Affirm Holdings, Inc. — Director's Dealing 2021

Jan 14, 2021

SEC Form 3 — Initial Statement of Beneficial Ownership

Issuer: Affirm Holdings, Inc. (AFRM)
CIK: 0001820953
Period of Report: 2021-01-13

Reporting Person: Rabois Keith (Director)

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	936909	Indirect
Class A Common Stock	60429	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Class B Common Stock	$		Class A Common Stock (2205293)		Indirect
Class B Common Stock	$		Class A Common Stock (545294)		Indirect
Class B Common Stock	$		Class A Common Stock (27418)		Indirect
Class B Common Stock	$		Class A Common Stock (936909)		Indirect
Class B Common Stock	$		Class A Common Stock (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 and The Founders Fund Growth Principals Fund, LP. 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: 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.