0001628280-21-024657.txt : 20211207 0001628280-21-024657.hdr.sgml : 20211207 20211207170722 ACCESSION NUMBER: 0001628280-21-024657 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211203 FILED AS OF DATE: 20211207 DATE AS OF CHANGE: 20211207 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Quarles Christa S CENTRAL INDEX KEY: 0001677329 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 211476733 MAIL ADDRESS: STREET 1: 351 PHELPS CITY: IRVING STATE: TX ZIP: 75038 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Affirm Holdings, Inc. CENTRAL INDEX KEY: 0001820953 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] 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_163891482561603.xml FORM 4 X0306 4 2021-12-03 0 0001820953 Affirm Holdings, Inc. AFRM 0001677329 Quarles Christa S C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 1 0 0 0 Class A Common Stock 2021-12-03 4 A 0 1864 0 A 127493 D Grant of Restricted Stock Units (RSUs) under the Issuer's Amended and Restated 2012 Stock Plan. The RSUs vest in full upon the earlier of December 3, 2022 or the date of the Issuer's next annual meeting of stockholders, subject to continued service by the Reporting Person as a non-employee director until such earlier date. Each Restricted Stock Unit represents a contingent right to receive one share of the Issuer's Class A Common Stock. /s/ David Ritenour, Attorney-in-Fact 2021-12-07