0001445305-22-000121.txt : 20220906 0001445305-22-000121.hdr.sgml : 20220906 20220906163226 ACCESSION NUMBER: 0001445305-22-000121 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220901 FILED AS OF DATE: 20220906 DATE AS OF CHANGE: 20220906 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: TROM JEFF D. CENTRAL INDEX KEY: 0001013632 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36773 FILM NUMBER: 221228650 MAIL ADDRESS: STREET 1: 2900 UNIVERSITY BLVD. CITY: AMES STATE: IA ZIP: 50010 FORMER NAME: FORMER CONFORMED NAME: TROM JEFF D DATE OF NAME CHANGE: 19960506 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WORKIVA INC CENTRAL INDEX KEY: 0001445305 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 472509828 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2900 UNIVERSITY BLVD. CITY: AMES STATE: IA ZIP: 50010 BUSINESS PHONE: (515) 817-6100 MAIL ADDRESS: STREET 1: 2900 UNIVERSITY BLVD. CITY: AMES STATE: IA ZIP: 50010 FORMER COMPANY: FORMER CONFORMED NAME: WORKIVA INC. DATE OF NAME CHANGE: 20141212 FORMER COMPANY: FORMER CONFORMED NAME: WORKIVA LLC DATE OF NAME CHANGE: 20140701 FORMER COMPANY: FORMER CONFORMED NAME: WEBFILINGS LLC DATE OF NAME CHANGE: 20091013 4 1 wf-form4_166249633067546.xml FORM 4 X0306 4 2022-09-01 0 0001445305 WORKIVA INC WK 0001013632 TROM JEFF D. 2900 UNIVERSITY BOULEVARD AMES IA 50010 0 1 0 0 Executive VP & CTO Class A Common Stock 2022-02-10 5 G 0 E 9947 0 D 292336 D Class A Common Stock 2022-02-10 5 G 0 E 9947 0 A 220611 I By revocable trust Class A Common Stock 2022-09-01 4 F 0 1429 64.92 D 290907 D Class B Common Stock Class A Common Stock 328402.0 328402 I By revocable trust Represents a gift of securities by the reporting person to a revocable living trust. Shares delivered to the issuer for payment of withholding taxes due upon the vesting of restricted stock units previously granted. Each 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). /s/ Brandon E. Ziegler as attorney-in-fact for Jeffrey D. Trom 2022-09-06