0001628280-23-040785.txt : 20231205 0001628280-23-040785.hdr.sgml : 20231205 20231205180152 ACCESSION NUMBER: 0001628280-23-040785 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231201 FILED AS OF DATE: 20231205 DATE AS OF CHANGE: 20231205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jiyane Siphelele CENTRAL INDEX KEY: 0001832806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 231467874 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_1701817303.xml FORM 4 X0508 4 2023-12-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001832806 Jiyane Siphelele C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Vice President, Controller 0 Class A Common Stock 2023-12-01 4 M 0 7411 0 A 170941 D Class A Common Stock 2023-12-01 4 F 0 2974 37.67 D 167967 D Restricted Stock Units 2023-12-01 4 M 0 3784 0 D 2027-10-26 Class A Common Stock 3784 10092 D Restricted Stock Units 2023-12-01 4 M 0 294 0 D 2028-07-14 Class A Common Stock 294 1670 D Restricted Stock Units 2023-12-01 4 M 0 1666 0 D Class A Common Stock 1666 10001 D Restricted Stock Units 2023-12-01 4 M 0 1667 0 D Class A Common Stock 1667 16667 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 December 1, 2023. Includes 1,811 shares of common stock purchased in exempt transactions under the issuer's employee stock purchase plan. Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock. With respect to the shares of Class A Common Stock underlying the RSUs, the RSUs vested in equal monthly installments from October 1, 2020 until August 1, 2023. Beginning September 1, 2023, the RSUs vest in equal quarterly installments, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. This grant has no expiration date. With respect to the shares of Class A Common Stock underlying the RSUs, the RSUs vested in equal monthly installments from July 1, 2021 until August 1, 2023. Beginning September 1, 2023, the RSUs vest in equal quarterly installments, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. This grant has no expiration date. With respect to the shares of Class A Common Stock underlying the RSUs, the RSUs vested in equal monthly installments from September 1, 2022 until August 1, 2023. Beginning September 1, 2023, the RSUs vest in equal quarterly installments, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. This grant has no expiration date. Grant of Restricted Stock Units (RSUs) under the Issuer's Amended and Restated 2012 Stock Plan. The RSUs vest in twelve quarterly installments beginning September 1, 2023. /s/ David Ritenour, Attorney-in-Fact 2023-12-05