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