0001628280-22-000239.txt : 20220104 0001628280-22-000239.hdr.sgml : 20220104 20220104180309 ACCESSION NUMBER: 0001628280-22-000239 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220101 FILED AS OF DATE: 20220104 DATE AS OF CHANGE: 20220104 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Adkins Katherine CENTRAL INDEX KEY: 0001870331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 22508065 MAIL ADDRESS: STREET 1: C/O AFFIRM HOLDINGS, INC. STREET 2: 650 CALIFORNIA STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94108 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Affirm Holdings, Inc. CENTRAL INDEX KEY: 0001820953 STANDARD INDUSTRIAL CLASSIFICATION: PERSONAL CREDIT INSTITUTIONS [6141] IRS NUMBER: 842224323 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 650 CALIFORNIA STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94108 BUSINESS PHONE: (415) 722-8633 MAIL ADDRESS: STREET 1: 650 CALIFORNIA STREET CITY: SAN FRANCISCO STATE: CA ZIP: 94108 4 1 wf-form4_164133735387850.xml FORM 4 X0306 4 2022-01-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001870331 Adkins Katherine C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Chief Legal Officer Class A Common Stock 2022-01-01 4 M 0 2490 0 A 2490 D Class A Common Stock 2022-01-01 4 F 0 827 100.56 D 1663 D Class A Common Stock 2022-01-03 4 M 0 2215 62.52 A 3878 D Class A Common Stock 2022-01-03 4 S 0 2215 102 D 1663 D Restricted Stock Units 2022-01-01 4 M 0 165 0 D Class A Common Stock 165.0 6788 D Restricted Stock Units 2022-01-01 4 M 0 2325 0 D 2027-10-26 Class A Common Stock 2325.0 16275 D Stock Option (Right to Buy) 62.52 2022-01-03 4 M 0 2215 0 D 2031-06-01 Class A Common Stock 2215.0 22700 D Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock. Represents the number of shares of the Issuer's Common Stock withheld to satisfy the Reporting Person's tax obligation in connection with the settlement of shares of Common Stock underlying the Reporting Person's restricted stock units that vested on January 1, 2022. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 14, 2021. The RSUs vest in 48 equal monthly installments after June 1, 2021, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. This grant has no expiration date. The RSUs vest in 24 equal monthly installments after August 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. The stock option vests in 48 equal monthly installments after June 1, 2021, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. /s/ David Ritenour, Attorney-in-Fact 2022-01-04