0001726978-22-000096.txt : 20220808 0001726978-22-000096.hdr.sgml : 20220808 20220808183041 ACCESSION NUMBER: 0001726978-22-000096 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220804 FILED AS OF DATE: 20220808 DATE AS OF CHANGE: 20220808 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: KEBODEAUX ADRIENNE CENTRAL INDEX KEY: 0001737826 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38466 FILM NUMBER: 221145858 MAIL ADDRESS: STREET 1: 1500 SOLANA BLVD STREET 2: BUILDING 4, SUITE 4500 CITY: WESTLAKE STATE: TX ZIP: 76262 FORMER NAME: FORMER CONFORMED NAME: Jones Adrienne DATE OF NAME CHANGE: 20180417 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_165999781610742.xml FORM 4 X0306 4 2022-08-04 0 0001726978 Goosehead Insurance, Inc. GSHD 0001737826 KEBODEAUX ADRIENNE C/O GOOSEHEAD INSURANCE, INC. 1500 SOLANA BLVD., BLDG 4, STE 4500 WESTLAKE TX 76262 0 0 1 1 Member of 10% owner group Class B Common Stock 2022-08-04 4 C 0 22662 0 D 358027 D Class A Common Stock 2022-08-04 4 C 0 22662 0 A 22662 D Class A Common Stock 2022-08-04 4 S 0 22662 60.2785 D 0 D Class B Common Stock 78530 I Chick and The Bear Irrevocable Trust LLC Units in Goosehead Financial, LLC 0.0 2022-08-04 4 C 0 22662 0 D Class A Common Stock 22662.0 358027 D LLC Units in Goosehead Financial, LLC 0.0 Class A Common Stock 78530.0 78530 I Chick and The Bear Irrevocable Trust The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $60.00 to $60.50 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. 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. /s/ P. Ryan Langston, as Attorney-in-Fact for Adrienne Kebodeaux 2022-08-08