0001628280-23-036815.txt : 20231103
0001628280-23-036815.hdr.sgml : 20231103
20231103181609
ACCESSION NUMBER: 0001628280-23-036815
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231101
FILED AS OF DATE: 20231103
DATE AS OF CHANGE: 20231103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Michalek Libor
CENTRAL INDEX KEY: 0001832810
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39888
FILM NUMBER: 231377671
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) 960-1518
MAIL ADDRESS:
STREET 1: 650 CALIFORNIA STREET
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94108
4
1
wk-form4_1699049756.xml
FORM 4
X0508
4
2023-11-01
0
0001820953
Affirm Holdings, Inc.
AFRM
0001832810
Michalek Libor
C/O AFFIRM HOLDINGS, INC.
650 CALIFORNIA STREET
SAN FRANCISCO
CA
94108
1
1
0
0
President
0
Class A Common Stock
2023-11-01
4
M
0
2336
0
A
126713
D
Class A Common Stock
2023-11-01
4
F
0
1159
17.61
D
125554
D
Class A Common Stock
873294
I
Michalek 2007 Trust dated March 21, 2007
Restricted Stock Units
2023-11-01
4
M
0
2336
0
D
Class A Common Stock
2336
79410
D
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 November 1, 2023.
The shares are held by the Michalek 2007 Family Trust dated March 21, 2007. The Reporting Person and his spouse are trustees of the trust.
Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock.
The RSUs vest in 48 equal monthly installments beginning October 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. This grant has no expiration date.
/s/ David Ritenour, Attorney-in-Fact
2023-11-03