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