SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Behar Jerome M

(Last) (First) (Middle)
2900 UNIVERSITY BOULEVARD

(Street)
AMES IA 50010

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
WORKIVA INC [ WK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
12/11/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
12/14/2015
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Class A Common Stock (1) 12/11/2015 S 15,000 D $18.003 4,357,268 I By Behar Living Trust (2)
Class A Common Stock (3) 12/14/2015 S 1,300 D $18.103 4,355,968 I By Behar Living Trust (2)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Behar Jerome M

(Last) (First) (Middle)
2900 UNIVERSITY BOULEVARD

(Street)
AMES IA 50010

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Behar Leslie F.

(Last) (First) (Middle)
2900 UNIVERSITY BOULEVARD

(Street)
AMES IA 50010

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Behar Living Trust

(Last) (First) (Middle)
2900 UNIVERSITY BOULEVARD

(Street)
AMES IA 50010

(City) (State) (Zip)
Explanation of Responses:
1. The price reported in Column 4 is a weighted-average price. The prices actually received range from $18.00 to $18.02. For all transactions reported in this Form 4 utilizing a weighted-average price, the reporting person undertakes to provide upon request by the SEC staff, the issuer, or a security holder of the issuer, full information regarding the number of shares sold at each separate price within the range.
2. Shares are owned directly by The Behar Living Trust (a 10% owner of the issuer), and indirectly by Jerome M. Behar and Leslie F. Behar as settlors of the Behar Living Trust.
3. The price reported in Column 4 is a weighted-average price. The prices actually received range from $18.10 to $18.11. For all transactions reported in this Form 4 utilizing a weighted-average price, the reporting person undertakes to provide upon request by the SEC staff, the issuer, or a security holder of the issuer, full information regarding the number of shares sold at each separate price within the range.
Remarks:
This amendment is being filed to correct the amount of Securities Beneficially Owned Following Reported Transactions and to reflect the fact that the second Form 4 filed by the reporting persons on December 14, 2015 was intended to amend the first Form 4 filed by the reporting persons on December 14, 2015.
/s/ Jerome M. Behar as trustee for The Behar Living Trust 12/14/2015
/s/ Jerome M. Behar 12/14/2015
/s/ Leslie Fried Behar 12/14/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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