0000950103-22-001968.txt : 20220203
0000950103-22-001968.hdr.sgml : 20220203
20220203060531
ACCESSION NUMBER: 0000950103-22-001968
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220202
FILED AS OF DATE: 20220203
DATE AS OF CHANGE: 20220203
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: McConnon Thomas
CENTRAL INDEX KEY: 0001908314
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 22586374
MAIL ADDRESS:
STREET 1: C/O WILDCAT CAPITAL MANAGEMENT, LLC
STREET 2: 888 7TH AVENUE, 37TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10106
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
dp166562_4-mcconnon.xml
FORM 4
X0306
4
2022-02-02
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001908314
McConnon Thomas
1500 SOLANA BLVD., BLDG 4, STE 4500
WESTLAKE
TX
76262
1
0
0
0
Director Stock Option (right to buy)
92.08
2022-02-02
4
A
0
12667
0
A
2032-02-02
Class A Common Stock
12667
12667
D
The shares subject to the option shall vest and become exercisable, subject to continued service, in 8 equal quarterly installments over the two (2) year period following the grant date; provided, that all shares subject to the option will vest and become exercisable upon a "change in control" (as defined in the issuer's omnibus incentive plan).
/s/ P. Ryan Langston, as attorney-in-fact for Thomas E. McConnon
2022-02-02