0001820953-21-000022.txt : 20210305
0001820953-21-000022.hdr.sgml : 20210305
20210305211351
ACCESSION NUMBER: 0001820953-21-000022
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210303
FILED AS OF DATE: 20210305
DATE AS OF CHANGE: 20210305
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: 21720418
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: 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_161499681202209.xml
FORM 4
X0306
4
2021-03-03
0
0001820953
Affirm Holdings, Inc.
AFRM
0001832810
Michalek Libor
C/O AFFIRM HOLDINGS, INC.
650 CALIFORNIA STREET
SAN FRANCISCO
CA
94108
0
1
0
0
President, Technology
Class A Common Stock
2021-03-03
4
M
0
263386
1.30
A
1138651
D
Class A Common Stock
2021-03-03
4
S
0
206791
89.5008
D
931860
D
Class A Common Stock
2021-03-03
4
S
0
56595
91.2936
D
875265
D
Stock Option (Right to Buy)
1.3
2021-03-03
4
M
0
263386
0
D
2020-01-01
2025-05-28
Class A Common Stock
263386.0
34691
D
Represents the weighted average sale price of the shares sold from $89.09 to $90.05 per share. The Reporting Person will provide, upon request by the Commission staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
Represents the weighted average sale price of the shares sold from $91.07 to $91.57 per share. The Reporting Person will provide, upon request by the Commission staff, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price within the range set forth in this footnote.
/s/ David Ritenour, Attorney-in-Fact
2021-03-05