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