0001820953-21-000038.txt : 20210405 0001820953-21-000038.hdr.sgml : 20210405 20210405204722 ACCESSION NUMBER: 0001820953-21-000038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210401 FILED AS OF DATE: 20210405 DATE AS OF CHANGE: 20210405 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Jiyane Siphelele CENTRAL INDEX KEY: 0001832806 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-39888 FILM NUMBER: 21807785 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_161766993649056.xml FORM 4 X0306 4 2021-04-01 0 0001820953 Affirm Holdings, Inc. AFRM 0001832806 Jiyane Siphelele C/O AFFIRM HOLDINGS, INC. 650 CALIFORNIA STREET SAN FRANCISCO CA 94108 0 1 0 0 Vice President, Controller Class A Common Stock 2021-04-01 4 M 0 3766 A 10126 D Class A Common Stock 2021-04-01 4 F 0 1870 71.45 D 8256 D Restricted Stock Units 2021-04-01 4 M 0 167 0 D 2026-08-22 Class A Common Stock 167.0 4000 D Restricted Stock Units 2021-04-01 4 M 0 1440 0 D 2027-10-26 Class A Common Stock 1440.0 23040 D Restricted Stock Units 2021-04-01 4 M 0 1263 0 D 2027-10-26 Class A Common Stock 1263.0 52976 D Restricted Stock Units 2021-04-01 4 M 0 896 0 D 2027-12-31 Class A Common Stock 896.0 18813 D Each Restricted Stock Unit represents a contingent right to receive one share of the Issuer's Class A Common Stock. Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of forty-eight months beginning on April 1, 2019, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of twenty-four months beginning on August 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of forty-eight months beginning on October 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. Restricted stock unit grant started vesting on January 1, 2021, and vests in equal monthly installments for a period of twenty-four months ending January 1, 2023, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. /s/ David Ritenour, Attorney-in-Fact 2021-04-05