0001726978-21-000073.txt : 20210510
0001726978-21-000073.hdr.sgml : 20210510
20210510182816
ACCESSION NUMBER: 0001726978-21-000073
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210506
FILED AS OF DATE: 20210510
DATE AS OF CHANGE: 20210510
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jones Mark Evan
CENTRAL INDEX KEY: 0001736768
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 21908953
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_162068568257089.xml
FORM 4
X0306
4
2021-05-06
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001736768
Jones Mark Evan
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
1
1
1
1
CEO
Member of 10% owner group
Class B Common Stock
2021-05-06
4
C
0
34054
0
D
12578002
I
By Trust
Class A Common Stock
2021-05-06
4
C
0
34054
0
A
34054
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
2021-05-06
4
S
0
19551
99.72
D
14503
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
2021-05-06
4
S
0
7709
100.60
D
6794
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
2021-05-06
4
S
0
5693
101.57
D
1101
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
2021-05-06
4
S
0
1101
102.42
D
0
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
286201
D
Class B Common Stock
182349
D
LLC Units in Goosehead Financial, LLC
0.0
2021-05-06
4
C
0
34054
0
D
Class A Common Stock
34054.0
12578002
I
By Trust
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
182349.0
182349
D
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.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $99.10 to $100.10, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $100.11 to $101.10, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $102.20 to $102.77, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4.
This does not reflect shares directly held by the reporting person's spouse, who is independently a reporting person of the issuer.
Each LLC Unit, together with a share of Class B common stock, may be converted by the holder into one share of Class A common stock at any time. The LLC Units do not expire.
/s/ P. Ryan Langston, as Attorney-in-Fact for Mark Evan Jones
2021-05-10