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: Jiyane Siphelele (Vice President, Controller)

Holdings (Non-Derivative)

Security	Shares	Ownership
Class A Common Stock	5000	Direct

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
Class B Common Stock	$		Class A Common Stock (5000)		Direct
Stock Options (right to buy)	$1.68	2026-08-24	Class A Common Stock (14367)		Direct
Stock Options (right to buy)	$2.04	2027-05-29	Class A Common Stock (12000)		Direct
Stock Options (right to buy)	$5.39	2028-02-12	Class A Common Stock (66166)		Direct
Stock Options (right to buy)	$8.80	2029-08-21	Class A Common Stock (30000)		Direct
Restricted Stock Units	$	2026-08-22	Class A Common Stock (8000)		Direct
Restricted Stock Units	$	2027-10-26	Class A Common Stock (60544)		Direct
Restricted Stock Units	$	2027-10-26	Class A Common Stock (34560)		Direct
Restricted Stock Units	$	2027-12-31	Class A Common Stock (21500)		Direct

Footnotes

F1: 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.

F2: Stock options vest with respect to 1/24 of the shares of the Issuer's Class A common stock, par value $0.00001 per share ("Class A Common Stock"), underlying the stock option on the one-year anniversary of July 5, 2016, the vesting commencement date of the Reporting Person's first stock option award from the Issuer, and the remaining shares underlying the option vest in equal monthly installments thereafter, in each case subject to continued service with the Issuer. The Reporting Person can elect to exercise the stock options at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule.

F3: Stock options vest with respect to the shares of Class A Common Stock underlying the stock option in equal monthly installments for a period of forty-eight months beginning on November 1, 2017, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. The Reporting Person can elect to exercise the stock options at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule.

F4: Stock options vest with respect to the shares of Class A Common Stock underlying the stock option in equal monthly installments for a period of forty-eight months beginning on April 1, 2019, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date. The Reporting Person can elect to exercise the stock options at any time, provided that the shares acquired upon exercise remain subject to the applicable vesting schedule.

F5: Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of forty-eight months beginning on April 1, 2019, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.

F6: Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of forty-eight months beginning on October 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.

F7: Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of twenty-four months beginning on August 1, 2020, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.

F8: Restricted stock units vest with respect to the shares of Class A Common Stock underlying the restricted stock units in equal monthly installments for a period of twenty-four months beginning on January 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.