0001628280-22-028310.txt : 20221103 0001628280-22-028310.hdr.sgml : 20221103 20221103185943 ACCESSION NUMBER: 0001628280-22-028310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221101 FILED AS OF DATE: 20221103 DATE AS OF CHANGE: 20221103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Rabois Keith CENTRAL INDEX KEY: 0001539865 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 221359707 MAIL ADDRESS: STREET 1: C/O YELP! INC. STREET 2: 706 MISSION ST. CITY: SAN FRANCISCO STATE: CA ZIP: 94103 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Affirm Holdings, Inc. CENTRAL INDEX KEY: 0001820953 STANDARD INDUSTRIAL CLASSIFICATION: PERSONAL CREDIT INSTITUTIONS [6141] 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_166751636539130.xml FORM 4 X0306 4 2022-11-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001539865 Rabois Keith ONE LETTERMAN DRIVE BUILDING D, 5TH FLOOR SAN FRANCISCO CA 94129 1 0 0 0 Class A Common Stock 2022-11-01 4 S 0 14269 19.8491 D 89452 D Class A Common Stock 2022-11-01 4 S 0 2818 20.9021 D 86634 D Class A Common Stock 2022-11-01 4 S 0 200 21.545 D 86434 D Class A Common Stock 75000 I By FF Affirm Growth, LLC Class A Common Stock 1486909 I By The Founders Fund Growth, LP Class A Common Stock 60429 I By The Founders Fund Growth Principals Fund, LP The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 15, 2022. Represents the weighted average sale price of the shares sold from $19.45 to $20.42 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. Reflects the receipt of 79,752 shares of Class A Common Stock pursuant to multiple pro rata distribution effected by Khosla Ventures to its members, including the Reporting Person, for no additional consideration. Represents the weighted average sale price of the shares sold from $20.45 to $21.40 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 $21.52 to $21.57 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. The Reporting Person has shared voting and investment power over the shares held by each of The Founders Fund Growth, LP, The Founders Fund Growth Principals Fund, LP and FF Affirm Growth, LLC. 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 any other purpose. /s/ David Ritenour, Attorney-in-Fact 2022-11-03