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