0001209191-21-004878.txt : 20210122
0001209191-21-004878.hdr.sgml : 20210122
20210122163241
ACCESSION NUMBER: 0001209191-21-004878
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210113
FILED AS OF DATE: 20210122
DATE AS OF CHANGE: 20210122
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: SHOPIFY INC.
CENTRAL INDEX KEY: 0001594805
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
STATE OF INCORPORATION: Z4
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39888
FILM NUMBER: 21546203
BUSINESS ADDRESS:
STREET 1: 151 O'CONNOR STREET
STREET 2: GROUND FLOOR
CITY: OTTAWA
STATE: A6
ZIP: K2P 2L8
BUSINESS PHONE: 613-241-2828
MAIL ADDRESS:
STREET 1: 151 O'CONNOR STREET
STREET 2: GROUND FLOOR
CITY: OTTAWA
STATE: A6
ZIP: K2P 2L8
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: 1231
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
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2021-01-13
0
0001820953
Affirm Holdings, Inc.
AFRM
0001594805
SHOPIFY INC.
150 O'CONNOR STREET, GROUND FLOOR
OTTAWA
A6
K2P 2L8
ONTARIO, CANADA
0
0
1
0
Class A Common Stock
10148797
D
Class B Common Stock
Class A Common Stock
10148797
D
Reflects the conversion of each share of the Issuer's Common Stock into one half of one share of Class A Common Stock and one half of one share of Class B Common Stock immediately prior to the consummation of the Issuer's initial public offering of Class A Common Stock and following the exercise of a warrant for 15,223,197 shares of the Issuer's Common Stock by Shopify Inc.
Each share of the Issuer's Class B Common Stock is convertible at any time into one share of the Issuer's Class A Common Stock. The Class B Common Stock has no expiration date.
Shopify Inc., By: /s/ Joseph Frasca, Name: Joseph Frasca, Title: Chief Legal Officer
2021-01-22