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Filing Details

Accession Number:: 0001209191-21-004575
Form Type:: 4
Zero Holdings:: No
Publication Time:: 2021-01-20 20:25:11
Reporting Period:: 2021-01-15

Accepted Time:: 2021-01-20 20:25:11
SEC Url:: Form 4 Filing

Issuer

Cik	Name	Symbol	Sector (SIC)	IRS No
1820953	Affirm Holdings Inc.	AFRM	()	4

Insiders

Cik	Name	Reported Address	Director	Officer	Large Shareholder	Other
1211060	Peter Thiel	C/O The Founders Fund One Letterman Drive, Building D, 5Th Flo San Francisco CA 94129	No	No	Yes	No
1601419	Founders Fund V, Lp	One Letterman Drive, Building D 5Th Floor San Francisco CA 94129	No	No	Yes	No
1601424	Founders Fund V Principals Fund, Lp	One Letterman Drive, Building D 5Th Floor San Francisco CA 94129	No	No	Yes	No
1697733	Founders Fund V Management, Llc	One Letterman Drive, Building D 5Th Floor San Francisco CA 94129	No	No	Yes	No
1813981	Founders Fund V Entrepreneurs Fund, Lp	One Letterman Drive, Building D 5Th Floor San Francisco CA 94129	No	No	Yes	No
1835462	Aaron Brian Singerman	C/O The Founders Fund One Letterman Drive, Building D, 5Th Flo San Francisco CA 94129	No	No	Yes	No

Reported Non-Derivative Transactions

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Sec. Name	Acquisiton - Disposition	Date	Amount	Price	Remaning Holdings	Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
Class A Common Stock	Acquisiton	2021-01-15	75,000	$49.00	75,000	No	4	P	Indirect	By Fund
Class A Common Stock	Acquisiton	2021-01-15	550,000	$0.00	1,486,909	No	4	C	Indirect	By Fund

Equity Swap Involved	Form Type	Code	Nature of Ownership	Explanation
No	4	P	Indirect	By Fund
No	4	C	Indirect	By Fund

Reported Derivative Transactions

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Sec. Name	Sec. Type	Acquisiton - Disposition	Date	Amount	Price	Amount - 2	Price - 2
Class A Common Stock	Class B Common Stock	Disposition	2021-01-15	550,000	$0.00	550,000	$0.00

Remaning Holdings	Exercise Date	Expiration Date	Equity Swap Involved	Transaction Form Type	Transaction Code	Nature of Ownership
386,909			No	4	C	Indirect

Reported Non-Derivative Holdings

Sec. Name	Remaning Holdings	Nature of Ownership	Explanation
Class A Common Stock	3,994,807	Indirect	By Fund
Class A Common Stock	1,074,604	Indirect	By Fund
Class A Common Stock	56,539	Indirect	By Fund
Class A Common Stock	2,205,293	Indirect	By Fund
Class A Common Stock	545,294	Indirect	By Fund
Class A Common Stock	27,418	Indirect	By Fund
Class A Common Stock	60,429	Indirect	By Fund
Class A Common Stock	142,857	Indirect	By LLC

Reported Derivative Holdings

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Sec. Name	Sec. Type	Price	Amount	Remaning Holdings	Nature of Ownership
Class A Common Stock	Class B Common Stock	$0.00	3,994,807	3,994,807	Indirect
Class A Common Stock	Class B Common Stock	$0.00	1,074,604	1,074,604	Indirect
Class A Common Stock	Class B Common Stock	$0.00	56,539	56,539	Indirect
Class A Common Stock	Class B Common Stock	$0.00	2,205,293	2,205,293	Indirect
Class A Common Stock	Class B Common Stock	$0.00	545,294	545,294	Indirect
Class A Common Stock	Class B Common Stock	$0.00	27,418	27,418	Indirect
Class A Common Stock	Class B Common Stock	$0.00	60,429	60,429	Indirect
Class A Common Stock	Class B Common Stock	$0.00	142,857	142,857	Indirect

Amount	Remaning Holdings	Nature of Ownership
3,994,807	3,994,807	Indirect
1,074,604	1,074,604	Indirect
56,539	56,539	Indirect
2,205,293	2,205,293	Indirect
545,294	545,294	Indirect
27,418	27,418	Indirect
60,429	60,429	Indirect
142,857	142,857	Indirect

Footnotes

Shares held by FF Affirm Growth, LLC ("FF-Affirm"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-Affirm and, accordingly, may be deemed to beneficially own the shares held by FF-Affirm. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer, files separate Section 16 reports, and reported this purchase on a Form 4 filed on January 15, 2021.
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.
Shares held by The Founders Fund Growth, LP ("FF-G"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-G and, accordingly, may be deemed to beneficially own the shares held by FF-G. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.
Shares held by The Founders Fund V, LP ("FF-V"). The Founders Fund V Management, LLC ("FF-VM") is the general partner of FF-V and may be deemed to beneficially own the shares held by FF-V. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-V and, accordingly, may be deemed to beneficially own the shares held by FF-V. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.
Shares held by The Founders Fund V Principals Fund, LP ("FF-VP"). FF-VM is the general partner of FF-VP and may be deemed to beneficially own the shares held by FF-VP. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-VP and, accordingly, may be deemed to beneficially own the shares held by FF-VP. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.
Shares held by The Founders Fund V Entrepreneurs Fund, LP ("FF-VE"). FF-VM is the general partner of FF-VE and may be deemed to beneficially own the shares held by FF-VE. Peter Thiel and Brian Singerman have shared voting and investment power over the shares held by FF-VE and, accordingly, may be deemed to beneficially own the shares held by FF-VE. Each of FF-VM, Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his or its respective pecuniary interest therein.
Shares held by The Founders Fund VI, LP ("FF-VI"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VI and, accordingly, may be deemed to beneficially own the shares held by FF-VI. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.
Shares held by The Founders Fund VI Principals Fund, LP ("FF-VIP"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VIP and, accordingly, may be deemed to beneficially own the shares held by FF-VIP. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.
Shares held by The Founders Fund VI Entrepreneurs Fund, LP ("FF-VIE"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-VIE and, accordingly, may be deemed to beneficially own the shares held by FF-VIE. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.
Shares held by The Founders Fund Growth Principals Fund, LP ("FF-GP"). Peter Thiel, Brian Singerman and Keith Rabois have shared voting and investment power over the shares held by FF-GP and, accordingly, may be deemed to beneficially own the shares held by FF-GP. Each of Mr. Thiel and Mr. Singerman disclaims beneficial ownership in these shares except to the extent of his respective pecuniary interest therein. Mr. Rabois is a director of the Issuer and files separate Section 16 reports.
Shares held by Rivendell Investments 3 LLC. Peter Thiel is the beneficial owner of Rivendell Investments 3 LLC and has sole voting and investment power over the shares held by Rivendell Investments 3 LLC.