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: Liew Jeremy (Director)

Holdings (Non-Derivative)

Security	Shares	Ownership
Class A Common Stock	934988	Indirect
Class A Common Stock	2459558	Indirect
Class A Common Stock	1254623	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Class B Common Stock	$		Class A Common Stock (934988)		Indirect
Class B Common Stock	$		Class A Common Stock (2459558)		Indirect
Class B Common Stock	$		Class A Common Stock (1254623)		Indirect
Restricted Stock Units	$	2028-01-12	Class A Common Stock (4081)		Direct

Footnotes

F1: Lightspeed Ultimate General Partner Select, Ltd. ("LUGP Select") is the sole general partner of Lightspeed General Partner Select, L.P., which is the sole general partner of Lightspeed Venture Partners Select, L.P. ("Lightspeed Select"). The Reporting Person is a director of LUGP Select and shares voting and dispositive power with respect to the shares held by Lightspeed Select. Lightspeed Ultimate General Partner Select II, Ltd. ("LUGP Select II") is the sole general partner of Lightspeed General Partner Select II, L.P., which is the sole general partner of Lightspeed Venture Partners Select II, L.P. ("Lightspeed Select II").The Reporting person is a director of LUGP Select II and shares voting and dispositive power with respect to the shares held by Lightspeed Select II. (continued in next footnote)

F2: Lightspeed Ultimate General Partner Opportunity Fund, Ltd. ("LUGP Opportunity") is the sole general partner of Lightspeed General Partner Opportunity Fund, L.P., which is the sole general partner of Lightspeed Opportunity Fund, L.P. ("Lightspeed Opportunity"). The Reporting Person is a director of LUGP Opportunity and shares voting and dispositive power with respect to the shares held by Lightspeed Opportunity. 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.

F3: 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.

F4: Restricted stock units vest in full upon the earlier of November 18, 2021 or the date of the Issuer's next annual meeting of stockholders, subject to continued service by the Reporting Person as a non-employee director until such earlier date.