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