0001726978-20-000135.txt : 20200504
0001726978-20-000135.hdr.sgml : 20200504
20200504181327
ACCESSION NUMBER: 0001726978-20-000135
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200501
FILED AS OF DATE: 20200504
DATE AS OF CHANGE: 20200504
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: 20846256
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_158863038356978.xml
FORM 4
X0306
4
2020-05-01
0
0001726978
Goosehead Insurance, Inc.
GSHD
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
Class B Common Stock
2020-05-01
4
C
0
100
0
D
13635643
I
By Trust
Class A Common Stock
2020-05-01
4
C
0
100
0
A
100
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
2020-05-01
4
S
0
100
60
D
0
I
By Mark and Robyn Jones Descendants Trust 2014
Class A Common Stock
742390
D
Class B Common Stock
182349
D
LLC Units in Goosehead Financial, LLC
0.0
2020-05-01
4
C
0
100
0
D
Class A Common Stock
100.0
13635643
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.
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.
The sales reported were effected pursuant to a Rule 10b5-1 trading plan adopted by the Mark and Robyn Jones Descendants Trust 2014. Following the reported transaction above, Mark and Robyn Jones, together with their trusts, continue to own beneficially 1,462,691 shares of Class A Common Stock and 14,000,341 shares of Class B Common Stock, for a total of 15,463,032 shares of Goosehead Insurance, Inc.
/s/ P. Ryan Langston, as Attorney-in-Fact for Robyn Mary Elizabeth Jones
2020-05-04