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AFRM Affirm Holdings Inc

31.71
-0.17 (-0.53%)
Last Updated: 16:30:41
Delayed by 15 minutes
Share Name Share Symbol Market Type
Affirm Holdings Inc NASDAQ:AFRM NASDAQ Common Stock
  Price Change % Change Share Price Bid Price Offer Price High Price Low Price Open Price Shares Traded Last Trade
  -0.17 -0.53% 31.71 31.69 31.70 32.26 31.27 31.43 1,279,424 16:30:41

Statement of Changes in Beneficial Ownership (4)

03/11/2021 10:02pm

Edgar (US Regulatory)


FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response...
0.5                       
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

Jiyane Siphelele
2. Issuer Name and Ticker or Trading Symbol

Affirm Holdings, Inc. [ AFRM ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

_____ Director                    _____ 10% Owner
__X__ Officer (give title below)    _____ Other (specify below)
Vice President, Controller
(Last)          (First)          (Middle)

C/O AFFIRM HOLDINGS, INC., 650 CALIFORNIA STREET
3. Date of Earliest Transaction (MM/DD/YYYY)

11/1/2021
(Street)

SAN FRANCISCO, CA 94108
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock 11/1/2021  M  3860 A (1)29552 D  
Class A Common Stock 11/1/2021  F  1684 (2)D$152.66 27868 D  
Class A Common Stock 11/1/2021  M  7894 A$2.04 35762 D  
Class A Common Stock 11/1/2021  S  1900 (3)D$151.5742 (4)33862 D  
Class A Common Stock 11/1/2021  S  4016 (3)D$152.4079 (5)29846 D  
Class A Common Stock 11/1/2021  S  17394 (3)D$153.5668 (6)12452 D  
Class A Common Stock 11/1/2021  S  4900 (3)D$154.5478 (7)7552 D  
Class A Common Stock 11/1/2021  S  1603 (3)D$155.1718 (8)5949 D  
Class A Common Stock 11/1/2021  S  1000 (3)D$156.552 (9)4949 D  
Class A Common Stock 11/1/2021  S  1300 (3)D$159.2685 (10)3649 D  
Class A Common Stock 11/1/2021  S  300 (3)D$159.8667 (11)3349 D  
Class A Common Stock 11/1/2021  S  481 (3)D$162.9308 (12)2868 D  

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security3. Trans. Date3A. Deemed Execution Date, if any4. Trans. Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
6. Date Exercisable and Expiration Date7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)11. Nature of Indirect Beneficial Ownership (Instr. 4)
CodeV(A)(D)Date ExercisableExpiration DateTitleAmount or Number of Shares
Restricted Stock Units  (1)11/1/2021  M     166   (13)8/22/2026 Class A Common Stock 166.0 $0 2834 D  
Restricted Stock Units  (1)11/1/2021  M     1440   (14)10/26/2027 Class A Common Stock 1440.0 $0 12960 D  
Restricted Stock Units  (1)11/1/2021  M     1260   (15)10/26/2027 Class A Common Stock 1260.0 $0 44148 D  
Restricted Stock Units  (1)11/1/2021  M     896   (16)12/31/2027 Class A Common Stock 896.0 $0 12542 D  
Restricted Stock Units  (1)11/1/2021  M     98   (17)7/14/2028 Class A Common Stock 98.0 $0 4321 D  
Stock Option (Right to Buy) $2.04 11/1/2021  M     7894   (18)5/29/2027 Class A Common Stock 7894.0 $0 4106 D  

Explanation of Responses:
(1) Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock.
(2) 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 November 1, 2021.
(3) The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person on September 15, 2021.
(4) Represents the weighted average sale price of the shares sold from $150.97 to $151.96 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.
(5) Represents the weighted average sale price of the shares sold from $152.03 to $152.97 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.
(6) Represents the weighted average sale price of the shares sold from $153.05 to $153.99 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.
(7) Represents the weighted average sale price of the shares sold from $154.05 to $155.03 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.
(8) Represents the weighted average sale price of the shares sold from $155.05 to $155.38 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.
(9) Represents the weighted average sale price of the shares sold from $156.12 to $157.01 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.
(10) Represents the weighted average sale price of the shares sold from $158.64 to $159.56 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.
(11) Represents the weighted average sale price of the shares sold from $159.73 to $159.94 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.
(12) Represents the weighted average sale price of the shares sold from $162.91 to $162.96 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.
(13) 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.
(14) RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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.
(15) RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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.
(16) RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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.
(17) RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in equal monthly installments for a period of forty-eight months beginning on July 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
(18) Stock option vests with respect to 1/24 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 July 5, 2016, the vesting commencement date of the Reporting Person's first stock option award from the Issuer, and the remaining shares underlying the option vest in equal monthly installments thereafter, in each case subject to continued service with the Issuer. The Reporting Person can elect to exercise the stock option at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director10% OwnerOfficerOther
Jiyane Siphelele
C/O AFFIRM HOLDINGS, INC.
650 CALIFORNIA STREET
SAN FRANCISCO, CA 94108


Vice President, Controller

Signatures
/s/ David Ritenour, Attorney-in-Fact11/3/2021
**Signature of Reporting PersonDate

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