0001628280-21-021554.txt : 20211103
0001628280-21-021554.hdr.sgml : 20211103
20211103180136
ACCESSION NUMBER: 0001628280-21-021554
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211101
FILED AS OF DATE: 20211103
DATE AS OF CHANGE: 20211103
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jiyane Siphelele
CENTRAL INDEX KEY: 0001832806
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39888
FILM NUMBER: 211376929
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_163597688046706.xml
FORM 4
X0306
4
2021-11-01
0
0001820953
Affirm Holdings, Inc.
AFRM
0001832806
Jiyane Siphelele
C/O AFFIRM HOLDINGS, INC.
650 CALIFORNIA STREET
SAN FRANCISCO
CA
94108
0
1
0
0
Vice President, Controller
Class A Common Stock
2021-11-01
4
M
0
3860
A
29552
D
Class A Common Stock
2021-11-01
4
F
0
1684
152.66
D
27868
D
Class A Common Stock
2021-11-01
4
M
0
7894
2.04
A
35762
D
Class A Common Stock
2021-11-01
4
S
0
1900
151.5742
D
33862
D
Class A Common Stock
2021-11-01
4
S
0
4016
152.4079
D
29846
D
Class A Common Stock
2021-11-01
4
S
0
17394
153.5668
D
12452
D
Class A Common Stock
2021-11-01
4
S
0
4900
154.5478
D
7552
D
Class A Common Stock
2021-11-01
4
S
0
1603
155.1718
D
5949
D
Class A Common Stock
2021-11-01
4
S
0
1000
156.552
D
4949
D
Class A Common Stock
2021-11-01
4
S
0
1300
159.2685
D
3649
D
Class A Common Stock
2021-11-01
4
S
0
300
159.8667
D
3349
D
Class A Common Stock
2021-11-01
4
S
0
481
162.9308
D
2868
D
Restricted Stock Units
2021-11-01
4
M
0
166
0
D
2026-08-22
Class A Common Stock
166.0
2834
D
Restricted Stock Units
2021-11-01
4
M
0
1440
0
D
2027-10-26
Class A Common Stock
1440.0
12960
D
Restricted Stock Units
2021-11-01
4
M
0
1260
0
D
2027-10-26
Class A Common Stock
1260.0
44148
D
Restricted Stock Units
2021-11-01
4
M
0
896
0
D
2027-12-31
Class A Common Stock
896.0
12542
D
Restricted Stock Units
2021-11-01
4
M
0
98
0
D
2028-07-14
Class A Common Stock
98.0
4321
D
Stock Option (Right to Buy)
2.04
2021-11-01
4
M
0
7894
0
D
2027-05-29
Class A Common Stock
7894.0
4106
D
Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock.
Represents the number of shares of the Issuer's Common Stock withheld to satisfy the Reporting Person's tax obligation in connection with the settlement of shares of Common Stock underlying the Reporting Person's restricted stock units that vested on November 1, 2021.
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, 2021.
Represents the weighted average sale price of the shares sold from $150.97 to $151.96 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 $152.03 to $152.97 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 $153.05 to $153.99 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 $154.05 to $155.03 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 $155.05 to $155.38 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 $156.12 to $157.01 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 $158.64 to $159.56 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 $159.73 to $159.94 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 $162.91 to $162.96 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.
Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of forty-eight months beginning on April 1, 2019, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in equal monthly installments for a period of twenty-four months beginning on August 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in equal monthly installments for a period of forty-eight months beginning on October 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in monthly installments for a period of twenty-four months beginning on January 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in equal monthly installments for a period of forty-eight months beginning on July 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
Stock option vests with respect to 1/24 of the shares of the Issuer's Class A common stock, par value $0.00001 per share ("Class A Common Stock"), underlying the stock option on the one-year anniversary of July 5, 2016, the vesting commencement date of the Reporting Person's first stock option award from the Issuer, and the remaining shares underlying the option vest in equal monthly installments thereafter, in each case subject to continued service with the Issuer. The Reporting Person can elect to exercise the stock option at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule.
/s/ David Ritenour, Attorney-in-Fact
2021-11-03