0001820953-21-000062.txt : 20210603
0001820953-21-000062.hdr.sgml : 20210603
20210603181323
ACCESSION NUMBER: 0001820953-21-000062
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210601
FILED AS OF DATE: 20210603
DATE AS OF CHANGE: 20210603
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: 21993998
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_162275838178281.xml
FORM 4
X0306
4
2021-06-01
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
2021-06-01
4
M
0
3333
A
8780
D
Class A Common Stock
2021-06-01
4
F
0
1653
62.52
D
7127
D
Restricted Stock Units
2021-06-01
4
M
0
3333
0
D
2027-12-31
Class A Common Stock
3333.0
63334
D
Each restricted stock unit represents a contingent right to receive one share of the Issuer's Class A Common Stock.
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 Class A Common Stock underlying the Reporting Person's restricted stock units that vested on June 1, 2021.
Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in monthly installments for a period of twenty-four months beginning on January 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
/s/ David Ritenour, Attorney-in-Fact
2021-06-03