SEC Form 4 · accession 0001013632-16-000004
WORKIVA INC · WK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeff D Trom
Officer — Executive VP & CTO · 10% Owner
Period of report
Jan 19, 2016
Accepted (ET)
Jan 21, 2016 · 4:49 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 StockF2,F1 | Jan 19, 2016 | A | 30,161 | — | A | 70,161 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option to Purchase Class A Common StockF3,F4 | $15.83 | holding | — | — | — | Aug 12, 2015 | Aug 11, 2024 | Class A Common Stock | 178,200 | 178,200 | D |
| Class B Common StockF5 | — | holding | — | — | — | — | — | Class A Common Stock | 1,881,533 | 1,881,533 | D |
| Class B Common StockF5 | — | holding | — | — | — | — | — | Class A Common Stock | 523,050 | 523,050 | I |
Explanation of responses
- F1Grant of restricted stock units pursuant to the 2014 Equity Incentive Plan.
- F2Vests in three equal annual installments commencing on the first anniversary of the grant date.
- F3Granted pursuant to 2009 Unit Incentive Plan.
- F4Vests 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.
- F5Each 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).