0001726978-22-000069.txt : 20220517
0001726978-22-000069.hdr.sgml : 20220517
20220517170121
ACCESSION NUMBER: 0001726978-22-000069
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220513
FILED AS OF DATE: 20220517
DATE AS OF CHANGE: 20220517
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: McConnon Thomas
CENTRAL INDEX KEY: 0001908314
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 22935538
MAIL ADDRESS:
STREET 1: C/O WILDCAT CAPITAL MANAGEMENT, LLC
STREET 2: 888 7TH AVENUE, 37TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10106
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_165282124136958.xml
FORM 4
X0306
4
2022-05-13
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001908314
McConnon Thomas
1500 SOLANA BOULEVARD
SUITE 4500
WESTLAKE
TX
76262
1
0
0
0
Director Stock Options (right to buy)
48.15
2022-05-13
4
A
0
10000
0
A
2032-05-13
Class A Common Stock
10000.0
10000
D
The shares subject to the option shall vest and become exercisable, subject to continued service, in 12 equal quarterly installments over the three (3) year period following the grant date; provided, that all shares subject to the option will vest and become exercisable upon a "change in control" (as defined in the Issuer's Amended and Restated Omnibus Incentive Plan).
/s/ P. Ryan Langston as Attorney-in-Fact for Thomas McConnon
2022-05-17