0001209191-23-037551.txt : 20230615 0001209191-23-037551.hdr.sgml : 20230615 20230615184522 ACCESSION NUMBER: 0001209191-23-037551 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230613 FILED AS OF DATE: 20230615 DATE AS OF CHANGE: 20230615 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Meeker Mary G CENTRAL INDEX KEY: 0001544567 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-37622 FILM NUMBER: 231018932 MAIL ADDRESS: STREET 1: 2750 SAND HILL ROAD CITY: MENLO PARK STATE: CA ZIP: 94025 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 X0407 4 2023-06-13 0 0001512673 Block, Inc. SQ 0001544567 Meeker Mary G 1955 BROADWAY SUITE 600 OAKLAND CA 94612 1 0 0 0 0 Class A Common Stock 2023-06-13 4 A 0 3815 0.00 A 410482 D Class A Common Stock 5817 I See Footnote Represents an automatic annual restricted stock unit (RSU) award issued pursuant to the Issuer's Outside Director Compensation Policy. Each RSU represents a contingent right to receive one share of Issuer's Class A Common Stock upon settlement. 100% of the RSUs vest on the earlier of June 13, 2024, or the date of the Issuer's next annual meeting of stockholders. The shares are held directly by KPCB sFund Associates, LLC ("sFund Associates"). The reporting person is a member of sFund Associates and may be deemed to share voting and investment power over the securities held by sFund Associates. The reporting person disclaims beneficial ownership over such securities except to the extent of her pecuniary interest therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes. /s/ Susan Szotek, Attorney-in-Fact 2023-06-15