SEC Info  
    Home      Search      My Interests      Help      Sign In      Please Sign In

Michalek Libor – ‘4’ for 9/16/22 re: Affirm Holdings, Inc.

On:  Tuesday, 9/20/22, at 8:31pm ET   ·   For:  9/16/22   ·   As:  Director and Officer   ·   Accession #:  1628280-22-25273   ·   File #:  1-39888

Previous ‘4’:  ‘4’ on 7/6/22 for 7/1/22   ·   Next:  ‘4’ on 10/4/22 for 10/1/22   ·   Latest:  ‘4’ on 4/12/24 for 4/11/24

Find Words in Filings emoji
 
  in    Show  and   Hints

  As Of               Filer                 Filing    For·On·As Docs:Size             Issuer                      Filing Agent

 9/20/22  Michalek Libor                    4          Dir.,Off.   1:7K   Affirm Holdings, Inc.             Workiva Inc Wde… FA01/FA

Statement of Changes in Beneficial Ownership of Securities by an Insider   —   Form 4   —   SEA’34

Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 4           Statement of Changes in Beneficial Ownership of     HTML      8K 
                Securities by an Insider --                                      
                wf-form4_166372025872405.xml/3.6                                 




        

This ‘4’ Document is an XML Data File that may be rendered in various formats:

  Form 4    –   Plain Text   –  SEC Website  –  EDGAR System  –    XML Data    –  <?xml?> File
 

 
XML Data rendering:  Statement of Changes in Beneficial Ownership of Securities by an Insider — wf-form4_166372025872405.xml/3.6
 
                                                                                                                                                                                
<?xml version="1.0" encoding="windows-1252"?>
<ownershipDocument>
<schemaVersion> X0306 </schemaVersion>
<documentType> 4 </documentType>
<periodOfReport> 2022-09-16 </periodOfReport>
<notSubjectToSection16> 0 </notSubjectToSection16>
<issuer>
<issuerCik> 0001820953 </issuerCik>
<issuerName> Affirm Holdings, Inc. </issuerName>
<issuerTradingSymbol> AFRM </issuerTradingSymbol>
</issuer>
<reportingOwner>
<reportingOwnerId>
<rptOwnerCik> 0001832810 </rptOwnerCik>
<rptOwnerName> Michalek Libor </rptOwnerName>
</reportingOwnerId>
<reportingOwnerAddress>
<rptOwnerStreet1> C/O AFFIRM HOLDINGS, INC. </rptOwnerStreet1>
<rptOwnerStreet2> 650 CALIFORNIA STREET </rptOwnerStreet2>
<rptOwnerCity> SAN FRANCISCO </rptOwnerCity>
<rptOwnerState> CA </rptOwnerState>
<rptOwnerZipCode> 94108 </rptOwnerZipCode>
<rptOwnerStateDescription></rptOwnerStateDescription>
</reportingOwnerAddress>
<reportingOwnerRelationship>
<isDirector> 1 </isDirector>
<isOfficer> 1 </isOfficer>
<isTenPercentOwner> 0 </isTenPercentOwner>
<isOther> 0 </isOther>
<officerTitle> President, Tech., Risk & Ops </officerTitle>
<otherText></otherText>
</reportingOwnerRelationship>
</reportingOwner>
<nonDerivativeTable>
<nonDerivativeHolding>
<securityTitle>
<value> Class A Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 86953 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
</directOrIndirectOwnership>
</ownershipNature>
</nonDerivativeHolding>
<nonDerivativeHolding>
<securityTitle>
<value> Class A Common Stock </value>
</securityTitle>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 875504 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> I </value>
</directOrIndirectOwnership>
<natureOfOwnership>
<value> Michalek 2007 Trust dated March 21, 2007 </value>
<footnoteId id="F1"/>
</natureOfOwnership>
</ownershipNature>
</nonDerivativeHolding>
</nonDerivativeTable>
<derivativeTable>
<derivativeTransaction>
<securityTitle>
<value> Restricted Stock Units </value>
</securityTitle>
<conversionOrExercisePrice>
<footnoteId id="F2"/>
</conversionOrExercisePrice>
<transactionDate>
<value> 2022-09-16 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> A </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 112107 </value>
</transactionShares>
<transactionPricePerShare>
<value> 0 </value>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> A </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<exerciseDate>
<footnoteId id="F3"/>
</exerciseDate>
<expirationDate>
<footnoteId id="F3"/>
</expirationDate>
<underlyingSecurity>
<underlyingSecurityTitle>
<value> Class A Common Stock </value>
</underlyingSecurityTitle>
<underlyingSecurityShares>
<value> 112107.0 </value>
</underlyingSecurityShares>
</underlyingSecurity>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 112107 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
</directOrIndirectOwnership>
</ownershipNature>
</derivativeTransaction>
<derivativeTransaction>
<securityTitle>
<value> Stock Option (Right to Buy) </value>
</securityTitle>
<conversionOrExercisePrice>
<value> 22.3 </value>
</conversionOrExercisePrice>
<transactionDate>
<value> 2022-09-16 </value>
</transactionDate>
<transactionCoding>
<transactionFormType> 4 </transactionFormType>
<transactionCode> A </transactionCode>
<equitySwapInvolved> 0 </equitySwapInvolved>
</transactionCoding>
<transactionAmounts>
<transactionShares>
<value> 204750 </value>
</transactionShares>
<transactionPricePerShare>
<value> 0 </value>
</transactionPricePerShare>
<transactionAcquiredDisposedCode>
<value> A </value>
</transactionAcquiredDisposedCode>
</transactionAmounts>
<exerciseDate>
<footnoteId id="F4"/>
</exerciseDate>
<expirationDate>
<value> 2032-09-16 </value>
</expirationDate>
<underlyingSecurity>
<underlyingSecurityTitle>
<value> Class A Common Stock </value>
</underlyingSecurityTitle>
<underlyingSecurityShares>
<value> 204750.0 </value>
</underlyingSecurityShares>
</underlyingSecurity>
<postTransactionAmounts>
<sharesOwnedFollowingTransaction>
<value> 204750 </value>
</sharesOwnedFollowingTransaction>
</postTransactionAmounts>
<ownershipNature>
<directOrIndirectOwnership>
<value> D </value>
</directOrIndirectOwnership>
</ownershipNature>
</derivativeTransaction>
</derivativeTable>
<footnotes>
<footnote id="F1"> The shares are held by the Michalek 2007 Family Trust dated March 21, 2007. The Reporting Person and his spouse are trustees of the trust. </footnote>
<footnote id="F2"> Each Restricted Stock Unit (RSU) represents a contingent right to receive one share of the Issuer's Class A Common Stock. </footnote>
<footnote id="F3"> The RSUs vest in 48 equal monthly installments beginning October 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. This grant has no expiration date. </footnote>
<footnote id="F4"> The stock options vest in 48 equal monthly installments beginning October 1, 2022, subject to the Reporting Person's continuous service with the Issuer as of each vesting date. </footnote>
</footnotes>
<remarks></remarks>
<ownerSignature>
<signatureName> /s/ David Ritenour, Attorney-in-Fact </signatureName>
<signatureDate> 2022-09-20 </signatureDate>
</ownerSignature>
</ownershipDocument>


Top
Filing Submission 0001628280-22-025273   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

Copyright © 2024 Fran Finnegan & Company LLC – All Rights Reserved.
AboutPrivacyRedactionsHelp — Sat., Apr. 27, 5:01:27.2am ET