Affirm Holdings, Inc. — Director's Dealing 2021

Mar 23, 2021

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: Affirm Holdings, Inc. (AFRM)
CIK: 0001820953
Period of Report: 2021-03-18

Reporting Person: Levchin Max R (Director, Chief Executive Officer, 10% Owner)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2021-03-18	Class A Common Stock	C	361759	—	Acquired	361759	Indirect
2021-03-18	Class A Common Stock	J	361759	—	Disposed	0	Indirect

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2021-03-18	Class B Common Stock	$	C	361759	Disposed		Class A Common Stock (361759.0)	Indirect

Holdings (Non-Derivative)

Security	Shares	Ownership
Class A Common Stock	735294	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Class B Common Stock	$		Class A Common Stock (735294.0)	735294	Indirect
Class B Common Stock	$		Class A Common Stock (15397650.0)	15397650	Direct

Footnotes

F1: The Reporting Person has sole voting and investment power over the shares held by 2012 MRL Investments LLC.

F2: Represents a pro-rata, in-kind distribution by 2012 MRL Investments LLC to its members (excluding the Reporting Person) without additional consideration.

F3: As joint settlors of the Levchin 2012 Irrevocable Trust, the Reporting Person and his spouse jointly have the right to acquire the shares held by the trust but do not have voting or investment power over such shares. 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.

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, par value $0.00001 per share. The Class B Common Stock has no expiration date.