0000899243-21-035719.txt : 20210913 0000899243-21-035719.hdr.sgml : 20210913 20210913181703 ACCESSION NUMBER: 0000899243-21-035719 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210909 FILED AS OF DATE: 20210913 DATE AS OF CHANGE: 20210913 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Philips Jeremy CENTRAL INDEX KEY: 0001536014 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 211250703 MAIL ADDRESS: STREET 1: C/O TRIPADVISOR, INC. STREET 2: 141 NEEDHAM STREET CITY: NEWTON STATE: MA ZIP: 02464 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 doc4.xml FORM 4 SUBMISSION X0306 4 2021-09-09 0 0001820953 Affirm Holdings, Inc. AFRM 0001536014 Philips Jeremy 137 NEWBURY STREET, 8TH FLOOR BOSTON MA 02116 1 0 0 0 Class A Common Stock 2021-09-09 4 C 0 40925 0.00 A 81850 I See Footnote Class A Common Stock 2021-09-09 4 C 0 4942 0.00 A 10641 I See Footnote Class A Common Stock 2021-09-09 4 C 0 484361 0.00 A 1042965 I See Footnote Class A Common Stock 2021-09-09 4 C 0 4134392 0.00 A 8268784 I See Footnote Class A Common Stock 2021-09-13 4 J 0 8268784 0.00 D 0 I See Footnote Class A Common Stock 2021-09-13 4 J 0 1959142 0.00 A 1959142 I See Footnote Class A Common Stock 2021-09-13 4 J 0 81850 0.00 D 0 I See Footnote Class A Common Stock 2021-09-13 4 J 0 76379 0.00 A 2035521 I See Footnote Class A Common Stock 2021-09-13 4 J 0 968722 0.00 D 74243 I See Footnote Class A Common Stock 2021-09-13 4 J 0 9687 0.00 A 9687 I See Footnote Class A Common Stock 2021-09-13 4 J 0 9884 0.00 D 757 I See Footnote Class B Common Stock 2021-09-09 4 C 0 40925 D Class A Common Stock 40925 0 I See Footnote Class B Common Stock 2021-09-09 4 C 0 4942 D Class A Common Stock 4942 0 I See Footnote Class B Common Stock 2021-09-09 4 C 0 484361 D Class A Common Stock 484361 0 I See Footnote Class B Common Stock 2021-09-09 4 C 0 4134392 D Class A Common Stock 4134392 0 I See Footnote These shares are held of record by Spark Capital Growth Founders' Fund, L.P. ("Spark Capital Growth FF"). Spark Growth Management Partners, LLC ("SGMP") is the general partner of Spark Capital Growth FF. The Reporting Person is the managing member of SGMP, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. These shares are held of record by Spark Capital Growth Founders' Fund III, L.P. ("Spark Capital Growth FF III"). Spark Growth Management Partners III, LLC ("SGMP III") is the general partner of Spark Capital Growth FF III. The Reporting Person is the managing member of SGMP III, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. These shares are held of record by Spark Capital Growth Fund III, L.P. ("Spark Capital Growth III"). SGMP III is the general partner of Spark Capital Growth III. The Reporting Person is the managing member of SGMP III, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. These shares are held of record by Spark Capital Growth Fund, L.P. ("Spark Capital Growth"). SGMP is the general partner of Spark Capital Growth. The Reporting Person is the managing member of SGMP, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Spark Capital Growth to its general and limited partners. Represents a change in the form of ownership of SGMP by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Spark Capital Growth. These shares are held of record by SGMP. The Reporting Person is the managing member of SGMP, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Spark Capital Growth FF to its general and limited partners. Represents a change in the form of ownership of SGMP by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Spark Capital Growth FF. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Spark Capital Growth III to its general and limited partners. Represents a change in the form of ownership of SGMP III by virtue of the receipt of shares as a result of the pro-rata in-kind distribution of common stock of the Issuer for no consideration by Spark Capital Growth III. These shares are held of record by SGMP III. The Reporting Person is the managing member of SGMP III, which makes all voting and investment decisions for the fund through its investment committee, of which the Reporting Person is also a member. The Reporting Person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose. Represents a pro-rata distribution, and not a purchase or sale, without additional consideration by Spark Capital Growth FF III to its limited partners. Each share of the Issuer's Class B common stock, par value $0.00001 per share ("Class B Common Stock"), is convertible at any time into one share of the Issuer's Class A common stock, par value $0.00001 per share. The Class B Common Stock has no expiration date. /s/ Jeremy Philips 2021-09-13