0001820953-21-000021.txt : 20210305 0001820953-21-000021.hdr.sgml : 20210305 20210305211328 ACCESSION NUMBER: 0001820953-21-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210303 FILED AS OF DATE: 20210305 DATE AS OF CHANGE: 20210305 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Martincevic Silvija CENTRAL INDEX KEY: 0001834580 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 21720416 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_161499679371555.xml FORM 4 X0306 4 2021-03-03 0 0001820953 Affirm Holdings, Inc. AFRM 0001834580 Martincevic Silvija C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Chief Commercial Officer Class A Common Stock 2021-03-03 4 M 0 34899 8.80 A 39085 D Class A Common Stock 2021-03-03 4 S 0 36999 91.281 D 2086 D Stock Option (Right to Buy) 8.8 2021-03-03 4 M 0 34899 0 D 2029-06-05 Class A Common Stock 34899.0 765101 D Represents the weighted average sale price of the shares sold from $91.00 to $91.65 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. Stock options vest with respect to 1/4 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 April 29, 2019, the vesting commencement date, and the remaining 3/4 of the shares underlying the option vest in equal monthly installments over the subsequent three years, in each case subject to continued service with the Issuer. The Reporting Person can elect to exercise the stock options at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule. /s/ David Ritenour, Attorney-in-Fact 2021-03-05