0001628280-21-021563.txt : 20211103 0001628280-21-021563.hdr.sgml : 20211103 20211103181114 ACCESSION NUMBER: 0001628280-21-021563 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: Adkins Katherine CENTRAL INDEX KEY: 0001870331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 211376987 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_163597745213443.xml FORM 4 X0306 4 2021-11-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001870331 Adkins Katherine C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Chief Legal Officer Class A Common Stock 2021-11-01 4 M 0 1660 62.52 A 10924 D Class A Common Stock 2021-11-01 4 M 0 2325 0 A 13249 D Class A Common Stock 2021-11-01 4 M 0 165 0 A 13414 D Class A Common Stock 2021-11-01 4 F 0 1128 152.66 D 12286 D Class A Common Stock 2021-11-01 4 S 0 1200 151.6433 D 11086 D Class A Common Stock 2021-11-01 4 S 0 3229 152.4063 D 7857 D Class A Common Stock 2021-11-01 4 S 0 901 153.6154 D 6956 D Class A Common Stock 2021-11-01 4 S 0 3700 154.6268 D 3256 D Class A Common Stock 2021-11-01 4 S 0 500 155.15 D 2756 D Class A Common Stock 2021-11-01 4 S 0 500 156.648 D 2256 D Class A Common Stock 2021-11-01 4 S 0 594 159.4839 D 1662 D Class A Common Stock 2021-11-01 4 S 0 300 162.9267 D 1362 D Stock Option (Right to Buy) 62.52 2021-11-01 4 M 0 1660 0 D 2031-06-01 Class A Common Stock 1660.0 24915 D Restricted Stock Units 2021-11-01 4 M 0 2325 0 D 2027-10-26 Class A Common Stock 2325.0 20925 D Restricted Stock Units 2021-11-01 4 M 0 165 0 D Class A Common Stock 165.0 7119 D 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 14, 2021. Represents the weighted average sale price of the shares sold from $151.03 to $151.98 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 $152.06 to $152.95 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 $153.10 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 $154.13 to $155.11 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 $155.13 to $155.17 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 $156.15 to $157.09 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 $158.99 to $159.93 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. The stock option vests in 48 equal monthly installments after June 1, 2021, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock. The RSUs vest in 24 equal monthly installments after August 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. The RSUs vest in 48 equal monthly installments after June 1, 2021, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. This grant has no expiration date. /s/ David Ritenour, Attorney-in-Fact 2021-11-03