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