Form Type: 4

SEC EDGAR Link
Accession Number:0001628280-21-023989
Date:2021-11-18
Issuer: AFFIRM HOLDINGS, INC. (AFRM)
Original Submission Date:

Reporting Person:

PHILIPS JEREMY
137 NEWBURY STREET, 8TH FLOOR
BOSTON, MA 02116

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
CLASS A COMMON STOCK 2021-11-18 M 4,082 a $0.00 757,808 direct
CLASS A COMMON STOCK 2021-11-18 0 $0.00 757 indirect f1
CLASS A COMMON STOCK 2021-11-18 0 $0.00 74,243 indirect f2
CLASS A COMMON STOCK 2021-11-18 0 $0.00 12,572 indirect f3
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
RESTRICTED STOCK UNITS 0.0 2021-11-18 deemed execution date M 4,082 (d) 2028-01-12 class a common stock 4,082 $0.00 0 direct
Footnotes
IDfootnote
f1 these shares are held of record by spark capital growth founders' fund iii, l.p. ("spark capital growth ff iii"). spark growth management partners iii, llc ("sgmp iii") is the general partner of spark capital growth ff iii. the reporting person is the managing member of sgmp iii, which makes all voting and investment decisions for the fund through its investment committee, of which the reporting person is also a member. the reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of section 16 or for any other purpose.
f2 these shares are held of record by spark capital growth fund iii, l.p. ("spark capital growth iii"). sgmp iii is the general partner of spark capital growth iii. the reporting person is the managing member of sgmp iii, which makes all voting and investment decisions for the fund through its investment committee, of which the reporting person is also a member. the reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of section 16 or for any other purpose.
f3 the shares are held by spark capital parters, llc ("scp"). the reporting person is a managing member of scp and may be deemed to share investment, voting and dispositive power over these shares. the reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, if any, and the inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of section 16 or for any other purpose.
f4 each restricted stock unit represents a contingent right to receive one share of the issuer's class a common stock.
f5 the number of rsus owned has been increased by one due to a rounding error on the reporting person's form 3 filed on january 13, 2021.
f6 restricted stock units vest in full upon the earlier of november 18, 2021 or the date of the issuer's next annual meeting of stockholders, subject to continued service by the reporting person as a non-employee director until such earlier date.
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