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