SEC FORM 4 SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
COBB WILLIAM C

(Last) (First) (Middle)
C/O H&R BLOCK
ONE H&R BLOCK WAY

(Street)
KANSAS CITY MO 64105

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
H&R BLOCK INC [ HRB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President and CEO
3. Date of Earliest Transaction (Month/Day/Year)
06/27/2017
4. If Amendment, Date of Original Filed (Month/Day/Year)
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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/27/2017 M 107,005 A $17.48 658,463.002 D
Common Stock 06/27/2017 M 81,970 A $19.14 740,433.002 D
Common Stock 06/27/2017 S 188,975 D $31.4298(1) 551,458.002 D
Common Stock 06/28/2017 M 198,765 A $17.48 750,223.002 D
Common Stock 06/28/2017 S 198,765 D $30.9641(2) 551,458.002 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Call Option to Purchase $17.48 06/27/2017 M 107,005 12/24/2011(3) 05/02/2021 Common Stock 107,005 $0.0000 499,465 D
Stock Option (Right to Buy) $19.14 06/27/2017 M 81,970 (4) 06/30/2021 Common Stock 81,970 $0.0000 0.0000 D
Call Option to Purchase $17.48 06/28/2017 M 198,765 12/24/2011(3) 05/02/2021 Common Stock 198,765 $0.0000 300,700 D
Explanation of Responses:
1. The price used is a weighted average of prices within the range of $31.340 to $31.571. The reporting person will provide full details of the price information reported upon a request from the Commission or any shareholder.
2. The price used is a weighted average of prices within the range of $30.800 to $31.560. The reporting person will provide full details of the price information reported upon a request from the Commission or any shareholder.
3. The options vested in three equal annual installments beginning on December 24, 2011.
4. The option vested in three equal installments on January 3, 2013, June 30, 2013, and June 30, 2014.
Scott W. Andreasen, per Power of Attorney 06/29/2017
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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