0001628280-22-008412.txt : 20220405
0001628280-22-008412.hdr.sgml : 20220405
20220405170326
ACCESSION NUMBER: 0001628280-22-008412
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220401
FILED AS OF DATE: 20220405
DATE AS OF CHANGE: 20220405
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Michalek Libor
CENTRAL INDEX KEY: 0001832810
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-39888
FILM NUMBER: 22807947
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: 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_164919258912184.xml
FORM 4
X0306
4
2022-04-01
0
0001820953
Affirm Holdings, Inc.
AFRM
0001832810
Michalek Libor
C/O AFFIRM HOLDINGS, INC.
650 CALIFORNIA STREET
SAN FRANCISCO
CA
94108
1
1
0
0
President, Tech., Risk & Ops
Class A Common Stock
2022-04-01
4
M
0
4225
0
A
85652
D
Class A Common Stock
2022-04-01
4
F
0
1462
46.61
D
84190
D
Class A Common Stock
877754
I
Michalek 2007 Trust dated March 21, 2007
Restricted Stock Units
2022-04-01
4
M
0
4225
0
D
Class A Common Stock
4225.0
94347
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 April 1, 2022.
The shares are held by the Michalek 2007 Family Trust dated March 21, 2007. The Reporting Person and his spouse are trustees of the trust.
Each Restricted Stock Unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.
Restricted stock unit grant vests over four and one-half years, commencing as of January 1, 2021, the vesting commencement date. The first 5% of the shares vest on the six-month anniversary of the vesting commencement date, and the remainder of the shares vest in quarterly installments over the remaining four years, in annual aggregate amounts equal to 15%, 20%, 30% and 30%, respectively, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
/s/ David Ritenour, Attorney-in-Fact
2022-04-05