Siphelele Jiyane - 09 Jun 2021 Form 4 Insider Report for Affirm Holdings, Inc. (AFRM)

Role
Vice President, Controller
Signature
/s/ David Ritenour, Attorney-in-Fact
Issuer symbol
AFRM
Transactions as of
09 Jun 2021
Net transactions value
-$200,227
Form type
4
Filing time
05 Oct 2021, 19:23:00 UTC
Previous filing
03 Jun 2021
Next filing
06 Jul 2021
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction AFRM Class A Common Stock Conversion of derivative security +5,000 +27% 23,527 09 Jun 2021 Direct F1
transaction AFRM Class A Common Stock Options Exercise +3,864 +16% 27,391 01 Oct 2021 Direct F2
transaction AFRM Class A Common Stock Tax liability $200,227 -1,699 -6.2% $117.85* 25,692 01 Oct 2021 Direct F3

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction AFRM Class B Common Stock Conversion of derivative security $0 -5,000 -100% $0.000000* 0 09 Jun 2021 Class A Common Stock 5,000 Direct F1
transaction AFRM Restricted Stock Units Options Exercise $0 -167 -5.3% $0.000000 3,000 01 Oct 2021 Class A Common Stock 167 Direct F2, F4
transaction AFRM Restricted Stock Units Options Exercise $0 -1,440 -9.1% $0.000000 14,400 01 Oct 2021 Class A Common Stock 1,440 Direct F2, F5
transaction AFRM Restricted Stock Units Options Exercise $0 -1,263 -2.7% $0.000000 45,408 01 Oct 2021 Class A Common Stock 1,263 Direct F2, F6
transaction AFRM Restricted Stock Units Options Exercise $0 -896 -6.3% $0.000000 13,438 01 Oct 2021 Class A Common Stock 896 Direct F2, F7
transaction AFRM Restricted Stock Units Options Exercise $0 -98 -2.2% $0.000000 4,419 01 Oct 2021 Class A Common Stock 98 Direct F2, F8, F9
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
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. The Class B Common Stock has no expiration date.
F2 Each Restricted Stock Unit (RSUs) represents a contingent right to receive one share of the Issuer's Class A Common Stock.
F3 Represents the number of shares of the Issuer's Common Stock withheld to satisfy the Reporting Person's tax obligation in connection with the settlement of shares of Common Stock underlying the Reporting Person's RSUs that vested on October 1, 2021.
F4 RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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.
F5 RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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.
F6 RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs 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 RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in 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.
F8 RSUs vest with respect to the shares of Class A Common Stock underlying the RSUs in equal monthly installments for a period of forty-eight months beginning on July 1, 2021, the vesting commencement date, subject to the Reporting Person's continued employment with the Issuer as of each vesting date.
F9 The total number of RSUs has been adjusted to correct for a prior administrative error with respect to the number of RSUs reported to be held by the Reporting Person.