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Affirm Holdings, Inc. — Director's Dealing 2021
May 26, 2021
30215_dirs_2021-05-25_942cca17-00f9-413f-a025-f6a3e41b3b2a.zip
Director's Dealing
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SEC Form 4 — Statement of Changes in Beneficial Ownership
Issuer: Affirm Holdings, Inc. (AFRM)
CIK: 0001820953
Period of Report: 2021-05-21
Reporting Person: Rabois Keith (Director)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2021-05-21 | Class A Common Stock | J | 2205293 | $0.00 | Disposed | 0 | Indirect |
| 2021-05-21 | Class A Common Stock | J | 545294 | $0.00 | Disposed | 0 | Indirect |
| 2021-05-21 | Class A Common Stock | J | 27418 | $0.00 | Disposed | 0 | Indirect |
| 2021-05-21 | Class A Common Stock | J | 23969 | $0.00 | Acquired | 23969 | Direct |
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2021-05-21 | Class B Common Stock | $ | J | 2205293 | Disposed | Class A Common Stock (2205293) | Indirect | |
| 2021-05-21 | Class B Common Stock | $ | J | 545294 | Disposed | Class A Common Stock (545294) | Indirect | |
| 2021-05-21 | Class B Common Stock | $ | J | 27418 | Disposed | Class A Common Stock (27418) | Indirect |
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Class A Common Stock | 1486909 | Indirect |
| Class A Common Stock | 60429 | Indirect |
| Class A Common Stock | 75000 | Indirect |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Class B Common Stock | $ | Class A Common Stock (386909) | 386909 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (60429) | 60429 | Indirect |
Footnotes
F1: Represents a pro rata distribution of shares of Class A common stock, par value $0.00001 per share ("Class A Common Stock") without additional consideration, by the holder to its general partner and limited partners. The Reporting Person did not receive any shares in this distribution.
F2: The Reporting Person has shared voting and investment power over the shares held by each of The Founders Fund VI, LP, The Founders Fund VI Principals Fund, LP, The Founders Fund VI Entrepreneurs Fund, LP, The Founders Fund Growth, LP, The Founders Fund Growth Principals Fund, LP and FF Affirm Growth, LLC. 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 any other purpose.
F3: Represents the receipt of shares of Class A Common Stock pursuant to a pro rata distribution effected by TFF V Employees LLC to its members, including the Reporting Person, for no additional consideration.
F4: Each share of the Issuer's Class B common stock, par value $0.00001 per share ("Class B Common Stock"), is convertible at any time into one share of the Issuer's Class A Common Stock. The Class B Common Stock has no expiration date.
F5: Represents a pro rata distribution of shares of Class B Common Stock, without additional consideration, by the holder to its general partner and limited partners. The Reporting Person did not receive any shares in this distribution.