0001726978-19-000249.txt : 20190718
0001726978-19-000249.hdr.sgml : 20190718
20190718162753
ACCESSION NUMBER: 0001726978-19-000249
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190717
FILED AS OF DATE: 20190718
DATE AS OF CHANGE: 20190718
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Colby Michael C.
CENTRAL INDEX KEY: 0001737258
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 19961586
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_156348165761128.xml
FORM 4
X0306
4
2019-07-17
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737258
Colby Michael C.
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
0
1
0
0
President and COO
Class B Common Stock
2019-07-17
4
C
0
2671
0
D
827024
D
Class A Common Stock
2019-07-17
4
C
0
2671
0
A
78302
D
Class A Common Stock
2019-07-17
4
S
0
2671
45.3083
D
75631
D
Class B Common Stock
858166
I
By Trust
Class A Common Stock
238402
I
By Colby 2014 Family Trust
LLC Units in Goosehead Financial, LLC
0.0
2019-07-17
4
C
0
2671
0
D
Class A Common Stock
2671.0
827024
D
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
858166.0
858166
I
By Trust
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held in trust for which the reporting person serves as a trustee and of which immediate family members of the reporting person are beneficiaries.
Each LLC Unit, together with a share of Class B Sommon Stock, may be converted by the holder into one share of Class A Common Stock at any time. The LLC Units do not expire.
The sales reported were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.
/s/ P. Ryan Langston, as Attorney-in-Fact for Michael C. Colby
2019-07-18