0001628280-22-001798.txt : 20220203 0001628280-22-001798.hdr.sgml : 20220203 20220203180601 ACCESSION NUMBER: 0001628280-22-001798 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220201 FILED AS OF DATE: 20220203 DATE AS OF CHANGE: 20220203 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Martincevic Silvija CENTRAL INDEX KEY: 0001834580 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 22590034 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_164392954598264.xml FORM 4 X0306 4 2022-02-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001834580 Martincevic Silvija C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Chief Commercial Officer Class A Common Stock 2022-02-01 4 M 0 3333 0 A 28685 D Class A Common Stock 2022-02-01 4 F 0 1153 67.48 D 27532 D Restricted Stock Units 2022-02-01 4 M 0 3333 0 D 2027-12-31 Class A Common Stock 3333.0 36667 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 February 1, 2022. RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in monthly installments for a period of twenty-four months beginning on January 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. /s/ David Ritenour, Attorney-in-Fact 2022-02-03