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Affirm Holdings, Inc. — Director's Dealing 2021
Jan 21, 2021
30215_dirs_2021-01-20_121ed017-6226-4a43-a4e2-dc33f44d833d.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: 2021-01-15
Reporting Person: Rabois Keith (Director)
Non-Derivative Transactions
| Date | Security | Code | Shares | Price | A/D | Holdings After | Ownership |
|---|---|---|---|---|---|---|---|
| 2021-01-15 | Class A Common Stock | C | 550000 | $0.00 | Acquired | 1486909 | Indirect |
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2021-01-15 | Class B Common Stock | $ | C | 550000 | Disposed | Class A Common Stock (5500000) | Indirect |
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Class A Common Stock | 2205293 | Indirect |
| Class A Common Stock | 545294 | Indirect |
| Class A Common Stock | 27418 | 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 (2205293) | 2205293 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (545294) | 545294 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (27418) | 27418 | Indirect | |
| Class B Common Stock | $ | Class A Common Stock (60429) | 60429 | Indirect |
Footnotes
F1: 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.
F2: 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 ("Class A Common Stock"). The Class B Common Stock has no expiration date.