3//SEC Filing
Khosla Ventures IV, L.P. 3
Accession 0000899243-21-001954
CIK 0001820953other
Filed
Jan 12, 7:00 PM ET
Accepted
Jan 13, 9:42 PM ET
Size
16.1 KB
Accession
0000899243-21-001954
Insider Transaction Report
Form 3
Khosla Ventures IV (CF), L.P.
10% Owner
Holdings
- 6,530,470(indirect: See footnote)
Class A Common Stock
- 417,504(indirect: See footnote)
Class A Common Stock
- (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (417,504 underlying) - (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (6,530,470 underlying)
Khosla Ventures IV, L.P.
10% Owner
Holdings
- 6,530,470(indirect: See footnote)
Class A Common Stock
- 417,504(indirect: See footnote)
Class A Common Stock
- (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (417,504 underlying) - (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (6,530,470 underlying)
Khosla Ventures Associates IV, LLC
10% Owner
Holdings
- 6,530,470(indirect: See footnote)
Class A Common Stock
- 417,504(indirect: See footnote)
Class A Common Stock
- (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (417,504 underlying) - (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (6,530,470 underlying)
VK Services, LLC
10% Owner
Holdings
- 417,504(indirect: See footnote)
Class A Common Stock
- (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (6,530,470 underlying) - (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (417,504 underlying) - 6,530,470(indirect: See footnote)
Class A Common Stock
KHOSLA VINOD
10% Owner
Holdings
- (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (6,530,470 underlying) - (indirect: See footnote)
Class B Common Stock
→ Class A Common Stock (417,504 underlying) - 6,530,470(indirect: See footnote)
Class A Common Stock
- 417,504(indirect: See footnote)
Class A Common Stock
Footnotes (4)
- [F1]Reflects the conversion of each share of the Issuer's Preferred Stock into Common Stock, and the conversion in turn of each share of the Issuer's Common Stock into one half of one share of Class A Common Stock and one half of one share of Class B Common Stock immediately prior to the consummation of the Issuer's initial public offering of Class A Common Stock.
- [F2]Consists of securities held of record by Khosla Ventures IV, L.P. ("KV IV"), of which Khosla Ventures Associates IV, LLC ("KVA IV") is the general partner. Vinod Khosla is the managing member of VK Services, LLC ("VK Services"), which is the sole manager of KVA IV. Each of KVA IV, VK Services and Vinod Khosla may be deemed to possess voting and investment control over such securities held by KV IV, and each of KVA IV, VK Services and Vinod Khosla may be deemed to have indirect beneficial ownership of such securities held by KV IV. Each Reporting Person disclaims beneficial ownership of such shares except to the extent of his or its respective pecuniary interests therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
- [F3]Consists of securities held of record by Khosla Ventures IV (CF), L.P. ("KV IV (CF)"), of which KVA IV is the general partner. Vinod Khosla is the managing member of VK Services, which is the sole manager of KVA IV. Each of KVA IV, VK Services and Vinod Khosla may be deemed to possess voting and investment control over such securities held by KV IV (CF), and each of KVA IV, VK Services, and Vinod Khosla may be deemed to have indirect beneficial ownership of such securities held by KV IV (CF). Each Reporting Person disclaims beneficial ownership of such shares except to the extent of his or its pecuniary interests therein, and the inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
- [F4]Each share of the Issuer's Class B Common Stock is convertible at any time into one share of the Issuer's Class A Common Stock. The Class B Common Stock has no expiration date.
Documents
Issuer
Affirm Holdings, Inc.
CIK 0001820953
Entity typeother
IncorporatedDE
Related Parties
1- filerCIK 0001521016
Filing Metadata
- Form type
- 3
- Filed
- Jan 12, 7:00 PM ET
- Accepted
- Jan 13, 9:42 PM ET
- Size
- 16.1 KB