0001628280-24-009095.txt : 20240305 0001628280-24-009095.hdr.sgml : 20240305 20240305180215 ACCESSION NUMBER: 0001628280-24-009095 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240301 FILED AS OF DATE: 20240305 DATE AS OF CHANGE: 20240305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jiyane Siphelele CENTRAL INDEX KEY: 0001832806 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 24722945 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] ORGANIZATION NAME: 02 Finance 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_1709679713.xml FORM 4 X0508 4 2024-03-01 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 2024-03-01 4 M 0 9495 0 A 201565 D Class A Common Stock 2024-03-01 4 F 0 3790 38.01 D 197775 D Restricted Stock Units 2024-03-01 4 M 0 3784 0 D 2027-10-26 Class A Common Stock 3784 6308 D Restricted Stock Units 2024-03-01 4 M 0 295 0 D 2028-07-14 Class A Common Stock 295 1375 D Restricted Stock Units 2024-03-01 4 M 0 1667 0 D Class A Common Stock 1667 8334 D Restricted Stock Units 2024-03-01 4 M 0 1666 0 D Class A Common Stock 1666 15001 D Restricted Stock Units 2024-03-01 4 M 0 2083 0 D Class A Common Stock 2083 22917 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 March 1, 2024. 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. 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. 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. RSUs vest with respect to the shares of Class A Common Stock underlying the restricted stock units in twelve quarterly installments beginning September 1, 2023, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. RSUs vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal quarterly installments for a period of three years beginning March 1, 2024, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. /s/ Josh Samples, Attorney-in-Fact 2024-03-05