Item 1.
Block, Inc.
| (b) | Address of Issuer’s Principal Executive Offices: |
1455 Market Street, Suite 600
San Francisco, CA 94103
Item 2.
| (a) | Name of Person Filing: |
Jack Dorsey
| (b) | Address of Principal Business Office or, if none, Residence: |
c/o Block, Inc.
1455 Market Street, Suite 600
San Francisco, CA 94103
Jack Dorsey is a U.S. citizen
| (d) | Title of Class of Securities: |
Class A Common Stock, $0.0000001 par value per share
852234 103
Item 3. | If this statement is filed pursuant to §§ 240.13d-1(b) or 240.13d-2(b) or 240.13d-2(c), check whether the person filing is a: |
Not applicable.
| (a) | Amount beneficially owned: |
As of December 31, 2021, (i) 36,763,992 shares of Class B Common Stock were held of record by the Jack Dorsey Revocable Trust u/a/d 12/8/10, for which Mr. Dorsey serves as trustee and (ii) 12,080,574 shares of Class B Common Stock were held of record by Start Small, LLC, for which Mr. Dorsey is the sole member.
Each share of Class B Common Stock is convertible into one share of Class A Common Stock at the option of the holder and has no expiration date. Each share of Class B Common Stock is entitled to ten votes per share, whereas each share of Class A Common Stock is entitled to one vote per share. The rights of the holders of Class A Common Stock and Class B Common Stock are identical, except with respect to the aforementioned conversion rights and voting rights.
10.8%
The ownership percentage above is calculated based on 403,237,209 shares of Class A Common Stock outstanding as of December 31, 2021, as reported by the Issuer to the Reporting Person, plus the assumed conversion of 48,844,566 shares of Class B Common Stock deemed beneficially owned by Mr. Dorsey, as described herein, into shares of Class A Common Stock.
| (c) | Number of shares as to which the person has: |