0001209191-22-023168.txt : 20220405
0001209191-22-023168.hdr.sgml : 20220405
20220405171653
ACCESSION NUMBER: 0001209191-22-023168
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220401
FILED AS OF DATE: 20220405
DATE AS OF CHANGE: 20220405
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Carter Shawn Corey
CENTRAL INDEX KEY: 0001549211
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37622
FILM NUMBER: 22808137
MAIL ADDRESS:
STREET 1: C/O S. CARTER ENTERPRISES, LLC
STREET 2: 1411 BROADWAY
CITY: NEW YORK
STATE: NY
ZIP: 10018
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Block, Inc.
CENTRAL INDEX KEY: 0001512673
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
IRS NUMBER: 800429876
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1455 MARKET STREET
STREET 2: SUITE 600
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94103
BUSINESS PHONE: 415-375-3176
MAIL ADDRESS:
STREET 1: 1455 MARKET STREET
STREET 2: SUITE 600
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94103
FORMER COMPANY:
FORMER CONFORMED NAME: Square, Inc.
DATE OF NAME CHANGE: 20110210
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2022-04-01
0
0001512673
Block, Inc.
SQ
0001549211
Carter Shawn Corey
1455 MARKET STREET
SUITE 600
SAN FRANCISCO
CA
94103
1
0
0
0
Class A Common Stock
2022-04-01
4
A
0
73
0.00
A
9890
D
Class A Common Stock
1779
I
By immediate family member
Class A Common Stock
20812
I
See Footnote
Class A Common Stock
296
I
See Footnote
Each share is represented by a restricted stock unit (RSU). Each RSU represents a contingent right to receive one share of the Issuer's Class A Common Stock upon settlement. The RSUs were issued pursuant to the Issuer's Outside Director Compensation Policy, and 100% of the RSUs were vested as of the date of grant.
The shares are held of record by an immediate family member of the Reporting Person.
The shares are held of record by SC Panther, LLC, for which the Reporting Person serves as the sole member.
The shares are held of record by SC Vessel 5, LLC, for which the Reporting Person serves as the sole member.
/s/ Susan Szotek, Attorney-in-Fact
2022-04-05