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