Affirm Holdings, Inc. — Director's Dealing 2021

Jan 21, 2021

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: Affirm Holdings, Inc. (AFRM)
CIK: 0001820953
Period of Report: 2021-01-15

Reporting Person: Founders Fund V Management, LLC (10% Owner)
Reporting Person: Founders Fund V Entrepreneurs Fund, LP (10% Owner)
Reporting Person: Founders Fund V Principals Fund, LP (10% Owner)
Reporting Person: Founders Fund V, LP (10% Owner)
Reporting Person: THIEL PETER (10% Owner)
Reporting Person: Singerman Brian Aaron (10% Owner)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2021-01-15	Class A Common Stock	P	75000	$49.00	Acquired	75000	Indirect
2021-01-15	Class A Common Stock	C	550000	—	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 (550000)	Indirect

Holdings (Non-Derivative)

Security	Shares	Ownership
Class A Common Stock	3994807	Indirect
Class A Common Stock	1074604	Indirect
Class A Common Stock	56539	Indirect
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	142857	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Class B Common Stock	$		Class A Common Stock (3994807)	3994807	Indirect
Class B Common Stock	$		Class A Common Stock (1074604)	1074604	Indirect
Class B Common Stock	$		Class A Common Stock (56539)	56539	Indirect
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
Class B Common Stock	$		Class A Common Stock (142857)	142857	Indirect

Footnotes

F1: Shares held by FF Affirm Growth, LLC ("FF-Affirm"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-Affirm and, accordingly, may be deemed to beneficially own the shares held by FF-Affirm. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer, files separate Section 16 reports, and reported this purchase on a Form 4 filed on January 15, 2021.

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.

F3: Shares held by The Founders Fund Growth, LP ("FF-G"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-G and, accordingly, may be deemed to beneficially own the shares held by FF-G. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.

F4: Shares held by The Founders Fund V, LP ("FF-V"). The Founders Fund V Management, LLC ("FF-VM") is the general partner of FF-V and may be deemed to beneficially own the shares held by FF-V. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-V and, accordingly, may be deemed to beneficially own the shares held by FF-V. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.

F5: Shares held by The Founders Fund V Principals Fund, LP ("FF-VP"). FF-VM is the general partner of FF-VP and may be deemed to beneficially own the shares held by FF-VP. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-VP and, accordingly, may be deemed to beneficially own the shares held by FF-VP. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.

F6: Shares held by The Founders Fund V Entrepreneurs Fund, LP ("FF-VE"). FF-VM is the general partner of FF-VE and may be deemed to beneficially own the shares held by FF-VE. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-VE and, accordingly, may be deemed to beneficially own the shares held by FF-VE. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.

F7: Shares held by The Founders Fund VI, LP ("FF-VI"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VI and, accordingly, may be deemed to beneficially own the shares held by FF-VI. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.

F8: Shares held by The Founders Fund VI Principals Fund, LP ("FF-VIP"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VIP and, accordingly, may be deemed to beneficially own the shares held by FF-VIP. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.

F9: Shares held by The Founders Fund VI Entrepreneurs Fund, LP ("FF-VIE"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VIE and, accordingly, may be deemed to beneficially own the shares held by FF-VIE. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.

F10: Shares held by The Founders Fund Growth Principals Fund, LP ("FF-GP"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-GP and, accordingly, may be deemed to beneficially own the shares held by FF-GP. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.

F11: Shares held by Rivendell Investments 3 LLC. Peter Thiel is the beneficial owner of Rivendell Investments 3 LLC and has sole voting and investment power over the shares held by Rivendell Investments 3 LLC.