0001628280-23-015325.txt : 20230503 0001628280-23-015325.hdr.sgml : 20230503 20230503180053 ACCESSION NUMBER: 0001628280-23-015325 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230501 FILED AS OF DATE: 20230503 DATE AS OF CHANGE: 20230503 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: 23885690 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_168315123891829.xml FORM 4 X0407 4 2023-05-01 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 0 Class A Common Stock 2023-05-01 4 M 0 6783 0 A 56872 D Class A Common Stock 2023-05-01 4 F 0 2054 9.99 D 54818 D Restricted Stock Units 2023-05-01 4 M 0 166 0 D Class A Common Stock 166.0 4139 D Restricted Stock Units 2023-05-01 4 M 0 305 0 D Class A Common Stock 305.0 9758 D Restricted Stock Units 2023-05-01 4 M 0 4911 0 D Class A Common Stock 4911.0 68761 D Restricted Stock Units 2023-05-01 4 M 0 1401 0 D Class A Common Stock 1401.0 56054 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 May 1, 2023. 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 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. The RSUs vest in 48 equal monthly installments beginning February 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 RSUs vest in 24 equal monthly installments beginning August 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 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. /s/ David Ritenour, Attorney-in-Fact 2023-05-03