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