0001726978-19-000127.txt : 20190506 0001726978-19-000127.hdr.sgml : 20190506 20190506181758 ACCESSION NUMBER: 0001726978-19-000127 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190503 FILED AS OF DATE: 20190506 DATE AS OF CHANGE: 20190506 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Colby Mark S. CENTRAL INDEX KEY: 0001736854 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38466 FILM NUMBER: 19800708 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_155718106285153.xml FORM 4 X0306 4 2019-05-03 0 0001726978 Goosehead Insurance, Inc. GSHD 0001736854 Colby Mark S. C/O GOOSEHEAD INSURANCE, INC. 1500 SOLANA BLVD., BUILDING 4, STE 4500 WESTLAKE TX 76262 0 1 0 0 Chief Financial Officer Class B Common Stock 2019-05-03 4 C 0 3509 0 D 95395 D Class A Common Stock 2019-05-03 4 C 0 3509 0 A 40646 D Class A Common Stock 2019-05-03 4 S 0 3509 35 D 37137 D LLC Units in Goosehead Financial, LLC 0.0 2019-05-03 4 C 0 3509 0 D Class A Common Stock 3509.0 95395 D 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. 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 Mark S. Colby 2019-05-06