0001628280-16-010838.txt : 20160208 0001628280-16-010838.hdr.sgml : 20160208 20160208165136 ACCESSION NUMBER: 0001628280-16-010838 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20160208 DATE AS OF CHANGE: 20160208 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: WORKIVA INC CENTRAL INDEX KEY: 0001445305 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 472509828 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-88683 FILM NUMBER: 161396180 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 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KIRBY STEVEN T CENTRAL INDEX KEY: 0001275098 FILING VALUES: FORM TYPE: SC 13G MAIL ADDRESS: STREET 1: 122 SOUTH PHILLIPS AVE, SUITE 122 CITY: SIOUX FALLS STATE: SD ZIP: 57104 FORMER COMPANY: FORMER CONFORMED NAME: KIRBY STEVE T DATE OF NAME CHANGE: 20040102 SC 13G 1 sc13g-kirby2016.htm SC 13G SC 13G


UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G/A
 
Under the Securities Exchange Act of 1934
(Amendment No.  1)*
 
Workiva Inc.
(Name of Issuer)
Class A Common Stock
(Title of Class of Securities)
98139A105

(CUSIP Number)
December 31, 2015
(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:
o
Rule 13d-1(b)
o
Rule 13d-1(c)
ý
Rule 13d-1(d)
 
*The remainder of this cover page shall be filled out for a reporting person’s initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page.
 
The information required in the remainder of this cover page shall not be deemed to be “filed” for the purpose of Section 18 of the Securities Exchange Act of 1934 (“Act”) or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes).




CUSIP No. 98139A105
 
 
1.
Names of Reporting Persons:
Steven T. Kirby
 
 
2.
Check the Appropriate Box if a Member of a Group (See Instructions)
 
 
(a)
 
o

 
 
(b)
 
o
 
 
3.
SEC Use Only
 
 
4.
Citizenship or Place of Organization:
United States of America
 
 
 
 
Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With:
5.
 
Sole Voting Power:
193,000
 
6.
 
Shared Voting Power:
-0-

 
7.
 
Sole Dispositive Power:
193,000
 
8.
 
Shared Dispositive Power:
-0-
 
 
9.
Amount Beneficially Owned by Each Reporting Person:
193,000 (1)

 
 
10.
Check if the Amount in Row (9) Excludes Certain Shares (See Instructions)  o
 
 
11.
Percent of Class Represented by Amount in Row (9):
0.7% (2)
 
 
12.
Type of Reporting Person (See Instructions):
IN
 
(1)
Includes 143,822 shares of Class A common stock owned by Mr. Kirby in his own name, and 49,178 shares of Class A common stock owned by Kirby Capital Corp., of which Mr. Kirby is the sole shareholder and has sole voting and dispositive power.

(2)
Based on 29,014,665 shares of Class A common stock outstanding as of December 31, 2015.









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Item 1.
 
 
 
 
(a)
Name of Issuer:
Workiva Inc.
 
(b)
Address of Issuer’s Principal Executive Offices:
2900 University Blvd
Ames, IA 50010

San Mateo, CA 94404
 
Item 2.
 
 
 
 
(a)
Names of Person Filing:
Steven T. Kirby
 
(b)
Address of Principal Business Office or, if none, Residence:
c/o Bluestem Capital Company, L.L.C.
101 S Phillips Ave.
Suite 501
Sioux Falls, SD 57104
 
(c)
Citizenship:
United States of America
 
(d)
Title of Class of Securities:
Class A Common Stock
 
(e)
CUSIP Number:
98139A105

 
Item 3.
If this statement is filed pursuant to §§240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a:
 
 
 
 
 
(a)
o
Broker or dealer registered under section 15 of the Act (15 U.S.C 78c).
 
 
 
 
 
(b)
o
Bank as defined in section 3(a) (6) of the Act (15 U.S.C 78c).
 
 
 
 
 
(c)
o
Insurance company as defined in section 3(a) (19) of the Act (15 U.S.C 78c).
 
 
 
 
 
(d)
o
Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8).
 
 
 
 
 
(e)
o
Investment adviser in accordance with SS 240. 13d-1(b) (1) (ii) (E);
 
 
 
 
 
(f)
o
Employee benefit plan or endowment fund in accordance with SS 240. 13d-1(b) (ii) (F);
 
 
 
 
 
(g)
o
Parent holding company or control person in accordance with SS.SS.240. 13d-1(b) (ii) (G);
 
 
 
 
 
(h)
o
A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
 
 
 
 
 
(i)
o
A church plan that is excluded from the definition of an investment company under section 3(c) (14) of the Investment Company Act of 1940 (15 U.S.C 80a-3);
 
 
 
 
 
(j)
o
Group, in accordance with SS 240. 13d-1(b) (1) (ii) (J);



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Item 4.
Ownership
 
 
 
 
Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.
 
(a)
Amount beneficially owned:    
193,000 (1)

 
(b)
Percent of class:   
0.7% (2)
 
(c)
Number of shares as to which the person has:
 
 
 
(i)
Sole power to vote or to direct the vote   
193,000

 
 
(ii)
Shared power to vote or to direct the vote    
-0-
 
 
(iii)
Sole power to dispose or to direct the disposition of   
193,000

 
 
(iv)
Shared power to dispose or to direct the disposition of   
-0-
 
 
 
 
(1)
Includes 143,822 shares of Class A common stock owned by Mr. Kirby in his own name, and 49,178 shares of Class A common stock owned by Kirby Capital Corp., of which Mr. Kirby is the sole shareholder and has sole voting and dispositive power.

(2)
Based on 29,014,665 shares of Class A common stock outstanding as of December 31, 2015.

Item 5.
Ownership of Five Percent or Less of a Class
 
 
 
Not Applicable
 
Item 6.
Ownership of More than Five Percent on Behalf of Another Person
 
 
 
Not Applicable
 
Item 7.
Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on By the Parent Holding Company or Control Person
 
 
 
Not Applicable
 
Item 8.
Identification and Classification of Members of the Group
 
 
 
Not Applicable
 
Item 9.
Notice of Dissolution of Group
 
 
 
Not Applicable
 
 
Item 10.
Certifications
 
 
 
Not Applicable
 

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SIGNATURE
 
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct.
 
 
Steven T. Kirby
 
 
 
Date: February 8, 2016
By:
/s/ Steven T. Kirby

 
 
Steven T. Kirby
 
 
 



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