0001628280-22-025272.txt : 20220920
0001628280-22-025272.hdr.sgml : 20220920
20220920203053
ACCESSION NUMBER: 0001628280-22-025272
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220916
FILED AS OF DATE: 20220920
DATE AS OF CHANGE: 20220920
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: 221254854
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_166372023868025.xml
FORM 4
X0306
4
2022-09-16
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
20669
D
Restricted Stock Units
2022-09-16
4
A
0
67264
0
A
Class A Common Stock
67264.0
67264
D
Stock Option (Right to Buy)
22.3
2022-09-16
4
A
0
122850
0
A
2032-09-16
Class A Common Stock
122850.0
122850
D
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 48 equal monthly installments beginning October 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. This grant has no expiration date.
The stock options vest in 48 equal monthly installments beginning October 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date.
/s/ David Ritenour, Attorney-in-Fact
2022-09-20