0001726978-21-000175.txt : 20210903 0001726978-21-000175.hdr.sgml : 20210903 20210903183639 ACCESSION NUMBER: 0001726978-21-000175 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210830 FILED AS OF DATE: 20210903 DATE AS OF CHANGE: 20210903 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: 211237815 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_163070858536319.xml FORM 4 X0306 4 2021-08-30 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 CFO Class A Common Stock 2021-08-30 4 M 0 0 10 A 8488 D Class A Common Stock 2021-08-30 4 S 0 7611 140.27 D 877 D Class A Common Stock 2021-09-30 4 S 0 877 141.28 D 0 D Class A Common Stock 2021-09-01 4 M 0 0 10 A 10000 D Class A Common Stock 2021-09-01 4 S 0 9478 150.43 D 522 D Class A Common Stock 2021-09-01 4 S 0 522 140 D 0 D Employee Stock Options (right to buy) 10.0 2021-09-01 4 M 0 0 0 D 2028-04-26 Class A Stock 0.0 40000 D The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $140.00 to $140.74, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $141.03 to $141.51, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $150.00 to $150.98, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $151.07 to $151.33, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in this footnote to this Form 4. One third (1/3rd) of the shares subject to the option shall vest and become exercisable, subject to continued employment, on each of the second, third and fourth anniversaries of the grant date; provided, that all shares subject to the option will vest and become exercisable if Mr. Colby's employment is terminated without "cause" or for "good reason" (each as defined in either Mr. Colby'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). 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 2021-09-03