0001726978-21-000204.txt : 20211230
0001726978-21-000204.hdr.sgml : 20211230
20211230170904
ACCESSION NUMBER: 0001726978-21-000204
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211229
FILED AS OF DATE: 20211230
DATE AS OF CHANGE: 20211230
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Colby Michael C.
CENTRAL INDEX KEY: 0001737258
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 211533617
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_164090212963558.xml
FORM 4
X0306
4
2021-12-29
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737258
Colby Michael C.
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
0
1
0
0
President and COO
Class B Common Stock
2021-12-29
4
C
0
801
0
D
400632
D
Class A Common Stock
2021-12-29
4
C
0
801
0
A
23932
D
Class A Common Stock
2021-12-29
4
S
0
801
130.1461
D
23131
D
Class B Common Stock
595341
I
By Colby 2014 Family Trust
Class A Common Stock
83402
I
By Colby 2014 Family Trust
Class B Common Stock
32896
I
By Preston Michael Colby 2014 Trust
Class B Common Stock
32896
I
By Lyla Kate Colby 2014 Trust
LLC Units in Goosehead Financial, LLC
0.0
2021-12-29
4
C
0
801
0
D
Class A Common Stock
801.0
400632
D
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
595431.0
595431
I
By Colby 2014 Family Trust
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
32896.0
32896
I
By Lyla Kate Colby 2014 Trust
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
32896.0
32896
I
By Preston Michael Colby 2014 Trust
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $130.00 to $130.54, 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.
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.
Each LLC Unit, together with a share of Class B Sommon Stock, may be converted by the holder into one share of Class A Common Stock at any time. The LLC Units do not expire.
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 on November 22, 2021, and which the Colby 2014 Family Trust sold 800 shares on the same day under the same trading plan.
/s/ P. Ryan Langston, as Attorney-in-Fact for Michael C. Colby
2021-12-30