Initial Statement of Beneficial Ownership (3)
02 Febbraio 2022 - 11:04PM
Edgar (US Regulatory)
FORM 3
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
0.5
|
|
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
|
|
|
1. Name and Address of Reporting Person
*
Rothstein Sharon |
2. Date of Event Requiring Statement (MM/DD/YYYY)
1/31/2022
|
3. Issuer Name and Ticker or Trading Symbol
Block, Inc. [SQ]
|
|
(Last)
(First)
(Middle)
1455 MARKET STREET, SUITE 600 |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__X__ Director _____ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
|
|
(Street)
SAN FRANCISCO, CA 94103
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Beneficially Owned
|
1.Title of Security
(Instr. 4) | 2. Amount of Securities Beneficially Owned
(Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5) | 4. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Class A Common Stock | 1256 (1) | D | |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 4) | 2. Date Exercisable and Expiration Date
(MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5) | 6. Nature of Indirect Beneficial Ownership
(Instr. 5) |
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| (1) | Represents ownership of CHESS Depositary Interests ("CDIs"), each representing an ownership interest in a share of Class A common stock of Block, Inc. ("Block"). As of January 31, 2022 (Pacific Standard Time), the Reporting Person held 3,350 American Depositary Shares, each representing one ordinary share of Afterpay Limited ("Afterpay"). On January 31, 2022 (Pacific Standard Time), each ordinary share of Afterpay was converted into the right to receive 0.375 shares of Block Class A common stock (or CDIs) as a result of Block's indirect acquisition of Afterpay in accordance with the Scheme Implementation Deed between Block, Lanai (AU) 2 Pty Ltd, and Afterpay, dated August 2, 2021 (Australian Eastern Standard Time), as amended December 7, 2021 (Australian Eastern Daylight Time). |
Reporting Owners
|
| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Rothstein Sharon
1455 MARKET STREET
SUITE 600
SAN FRANCISCO, CA 94103 | X |
|
|
|
Signatures
|
| /s/ Susan Szotek, Attorney-in-Fact | | 2/2/2022 |
| **Signature of Reporting Person | Date |
Grafico Azioni Block (NYSE:SQ)
Storico
Da Giu 2024 a Lug 2024
Grafico Azioni Block (NYSE:SQ)
Storico
Da Lug 2023 a Lug 2024
