0001726978-21-000171.txt : 20210830
0001726978-21-000171.hdr.sgml : 20210830
20210830120743
ACCESSION NUMBER: 0001726978-21-000171
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210830
FILED AS OF DATE: 20210830
DATE AS OF CHANGE: 20210830
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Langston Patrick Ryan
CENTRAL INDEX KEY: 0001736766
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 211222001
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_163033964890653.xml
FORM 4
X0306
4
2021-08-30
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001736766
Langston Patrick Ryan
1500 SOLANA BLVD
BUILDING 4, SUITE 4500
WESTLAKE
TX
76262
0
1
1
1
VP and General Counsel
Member of 10% owner group
Class A Common Stock
2021-08-30
4
M
0
0
10
A
15000
D
Class A Common Stock
2021-08-30
4
S
0
10000
140.06
D
5000
D
Employee Stock Options (right to buy)
10.0
2021-08-30
4
M
0
0
0
D
2028-04-26
Class A Stock
0.0
60000
D
One third (1/3rd) of the option, which represents the right to purchase a total of 120,000 shares, shall vest and become exercisable, subject to continued employment, on each of the second, third and fourth anniversaries of the grant date, which was April 26, 2018; provided, that all shares subject to the option will vest and become exercisable if Mr. Langston's employment is terminated without "cause" or for "good reason" (each as defined in either Mr. Langston's option award agreement or the issuer's omnibus incentive plan) within six month following a "change in control" (as defined in the issuer's omnibus incentive plan).
/s/ P. Ryan Langston
2021-08-30