0001726978-18-000014.txt : 20180814 0001726978-18-000014.hdr.sgml : 20180814 20180814104423 ACCESSION NUMBER: 0001726978-18-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180810 FILED AS OF DATE: 20180814 DATE AS OF CHANGE: 20180814 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Burks Drew CENTRAL INDEX KEY: 0001737235 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38466 FILM NUMBER: 181015146 MAIL ADDRESS: STREET 1: 1500 SOLANA BLVD STREET 2: BUILDING 4, SUITE 4500 CITY: WESTLAKE STATE: TX ZIP: 76262 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Goosehead Insurance, Inc. CENTRAL INDEX KEY: 0001726978 STANDARD INDUSTRIAL CLASSIFICATION: INSURANCE AGENTS BROKERS & SERVICES [6411] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1500 SOLANA BLVD STREET 2: BUILDING 4, SUITE 4500 CITY: WESTLAKE STATE: TX ZIP: 76262 BUSINESS PHONE: 214-838-5500 MAIL ADDRESS: STREET 1: 1500 SOLANA BLVD STREET 2: BUILDING 4, SUITE 4500 CITY: WESTLAKE STATE: TX ZIP: 76262 4 1 wf-form4_153425784462580.xml FORM 4 X0306 4 2018-08-10 0 0001726978 Goosehead Insurance, Inc. GSHD 0001737235 Burks Drew C/O GOOSEHEAD INSURANCE, INC. 1500 SOLANA BLVD., BLDG 4, SUITE 4500 WESTLAKE TX 76262 0 1 0 0 Chief Information Officer Class A Common Stock 2018-08-10 4 P 0 39 27.48 A 39 D /s/ P. Ryan Langston, as Attorney-in-Fact for Drew Burks 2018-08-13