SEC Form 4 · accession 0001013631-16-000028

WORKIVA INC · WK

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Officer — Chairman & CEO · Director · 10% Owner

Period of report

Nov 14, 2016

Accepted (ET)

Nov 16, 2016 · 6:23 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001445305

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Stock^F1	holding	—	—		—	186,491	D
Class A Common Stock	holding	—	—		—	575,000	I	By Trust

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Class B Common Stock^F2	—	Nov 14, 2016	G	114,000	D	—	—	Class A Common Stock	114,000	1,292,058	I
Class B Common Stock^F2	—	Nov 14, 2016	G	76,000	A	—	—	Class A Common Stock	76,000	201,630	I
Class B Common Stock^F2	—	holding	—	—	—	—	—	Class A Common Stock	32,783	32,783	D
Class B Common Stock^F2	—	holding	—	—	—	—	—	Class A Common Stock	662,467	662,467	I
Class B Common Stock^F2	—	holding	—	—	—	—	—	Class A Common Stock	885,109	885,109	I
Employee Stock Option to Purchase Class A Common Stock^F3,F4	$14.74	holding	—	—	—	Feb 1, 2017	Feb 1, 2026	Class A Common Stock	168,421	168,421	D
Employee Stock Option to Purchase Class A Common Stock^F5,F6	$15.83	holding	—	—	—	Aug 12, 2015	Aug 11, 2024	Class A Common Stock	178,200	178,200	D

F1Includes unvested restricted stock units.
F2Each share of Class B Common Stock is convertible, at any time at the election of the holder, into one share of Class A Common Stock. In addition, each share of Class B Common Stock will convert automatically into one share of Class A Common Stock upon (i) the date specified by the holders of at least 66 2/3% of the outstanding shares of Class B Common Stock, (ii) any transfer, except for certain "qualified transfers" (as defined in the Issuer's Certificate of Incorporation) or (iii) upon the death of a natural person holding shares of Class B Common Stock (subject to certain exceptions as defined in the Issuer's Certificate of Incorporation).
F3Granted pursuant to the 2014 Equity Incentive Plan.
F4Vests in three equal annual installments commencing on the first anniversary of the grant date.
F5Granted pursuant to 2009 Unit Incentive Plan.
F6Vests as to 25% of the shares on the first anniversary of the grant date and as to 6.25% of the shares at the end of each three-month period thereafter.