0001726978-23-000117.txt : 20230830
0001726978-23-000117.hdr.sgml : 20230830
20230830191211
ACCESSION NUMBER: 0001726978-23-000117
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230829
FILED AS OF DATE: 20230830
DATE AS OF CHANGE: 20230830
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: 231226460
MAIL ADDRESS:
STREET 1: 1500 SOLANA BLVD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Desiree Robyn Coleman Family Trust 2014
CENTRAL INDEX KEY: 0001737804
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 231226461
BUSINESS ADDRESS:
STREET 1: 1500 SOLANA BOULEVARD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
BUSINESS PHONE: 214-838-5200
MAIL ADDRESS:
STREET 1: 1500 SOLANA BOULEVARD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jones Robyn Mary Elizabeth
CENTRAL INDEX KEY: 0001737503
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 231226459
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
wk-form4_1693437113.xml
FORM 4
X0508
4
2023-08-29
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737804
Desiree Robyn Coleman Family Trust 2014
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BLDG 4, STE 4500
WESTLAKE
TX
76262
0
0
1
1
Member of 10% owner group
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
0001737503
Jones Robyn Mary Elizabeth
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
1
0
1
1
Member of 10% owner group
0
Class B Common Stock
2023-08-29
4
C
0
4000
0
D
291834
D
Class A Common Stock
2023-08-29
4
C
0
4000
0
A
4000
D
Class A Common Stock
2023-08-29
4
S
0
1845
68.67
D
2155
D
Class A Common Stock
2023-08-29
4
S
0
2155
69.73
D
0
D
Class A Common Stock
196501
D
Class B Common Stock
182349
D
Class A Common Stock
181290
D
Class B Common Stock
132349
D
Class B Common Stock
9720663
I
By Trust
LLC Units in Goosehead Financial, LLC
0
2023-08-29
4
C
0
4000
0
D
Class A Common Stock
4000
291834
D
LLC Units in Goosehead Financial, LLC
0
Class A Common Stock
182349
182349
D
LLC Units in Goosehead Financial, LLC
0
Class A Common Stock
132349
132349
D
LLC Units in Goosehead Financial, LLC
0
Class A Common Stock
9720663
9720663
I
By Trust
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held (i) directly by the Desiree Robyn Coleman Family Trust 2014 and (ii) indirectly by Mark Evan
Jones and Robyn Mary Elizabeth Jones, who serve as trustees of the Desiree Robyn Coleman Family Trust 2014 and whose immediate family members are beneficiaries of the Desiree Robyn Coleman Family Trust 2014.
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $68.51 to $69.30, 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.
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held directly by Mark Evan Jones, and does not reflect Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held by his spouse, Robyn Mary Elizabeth Jones, who is independently a reporting person of the issuer.
Reflects a reduction in shares due to a same-day gift from Robyn Mary Elizabeth Jones, for which a separate Form 4 will be filed.
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held directly by Robyn Mary Elizabeth Jones, and does not reflect Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held by her spouse, Mark Evan Jones, who is independently a reporting person of the issuer.
Reflects shares of Class B Common Stock or LLC Units, as applicable, held indirectly by Mark Evan Jones and Robyn Mary Elizabeth Jones, who serve as trustees of various trusts and whose immediate family members are beneficiaries of such trusts.
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/ John O'Connor, as Attorney-in-Fact for Desiree Robyn Coleman Family Trust 2014
2023-08-30
/s/ John O'Connor, as Attorney-in-Fact for Mark Evan Jones
2023-08-30
/s/ John O'Connor, as Attorney-in-Fact for Robyn Mary Elizabeth Jones
2023-08-30