0001726978-23-000021.txt : 20230227
0001726978-23-000021.hdr.sgml : 20230227
20230227171737
ACCESSION NUMBER: 0001726978-23-000021
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230223
FILED AS OF DATE: 20230227
DATE AS OF CHANGE: 20230227
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jones Mark Evan
CENTRAL INDEX KEY: 0001736768
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 23676637
MAIL ADDRESS:
STREET 1: 1500 SOLANA BLVD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jones Robyn Mary Elizabeth
CENTRAL INDEX KEY: 0001737503
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 23676636
MAIL ADDRESS:
STREET 1: 1500 SOLANA BLVD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mark & Robyn Jones Descendants Trust 2014
CENTRAL INDEX KEY: 0001736769
STATE OF INCORPORATION: TX
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 23676639
BUSINESS ADDRESS:
STREET 1: 1500 SOLANA BOULEVARD
STREET 2: BUILDING 4, SUITE 4500
CITY: WESTLAKE
STATE: TX
ZIP: 76262
BUSINESS PHONE: 214-838-5200
MAIL ADDRESS:
STREET 1: 1500 SOLANA BOULEVARD
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_167753623386723.xml
FORM 4
X0306
4
2023-02-23
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001736769
Mark & Robyn Jones Descendants Trust 2014
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BLDG 4, STE 4500
WESTLAKE
TX
76262
0
0
1
1
Member of 10% owner group
0001736768
Jones Mark Evan
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
1
1
1
1
CEO
Member of 10% owner group
0001737503
Jones Robyn Mary Elizabeth
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
1
0
1
1
Member of 10% owner group
Class B Common Stock
2023-02-23
4
C
0
814
0
D
8706142
D
Class A Common Stock
2023-02-23
4
C
0
814
0
A
814
D
Class A Common Stock
2023-02-23
4
S
0
814
45
D
0
D
Class A Common Stock
196501
D
Class B Common Stock
182349
D
Class A Common Stock
331290
D
Class B Common Stock
132349
D
Class B Common Stock
1860355
I
By Trust
LLC Units in Goosehead Financial, LLC
0.0
2023-02-23
4
C
0
814
0
D
Class A Common Stock
814.0
8706142
D
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
182349.0
182349
D
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
132349.0
132349
D
LLC Units in Goosehead Financial, LLC
0.0
Class A Common Stock
1860355.0
1860355
I
By Trust
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held (i) directly by the Mark & Robyn Jones Descendants Trust 2014 and (ii) indirectly by Mark Evan Jones and Robyn Mary Elizabeth Jones, who serve as trustees of the Mark & Robyn Jones Descendants Trust 2014 and whose immediate family members are beneficiaries of the Mark & Robyn Jones Descendants Trust 2014.
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held directly by Mark Evan Jones, and does not reflect Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held by his spouse, Robyn Mary Elizabeth Jones, who is independently a reporting person of the issuer.
Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held directly by Robyn Mary Elizabeth Jones, and does not reflect Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held by her spouse, Mark Evan Jones, who is independently a reporting person of the issuer.
Reflects shares of Class B Common Stock or LLC Units, as applicable, held indirectly by Mark Evan Jones and Robyn Mary Elizabeth Jones, who serve as trustees of various trusts and whose immediate family members are beneficiaries of such trusts.
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 Mark and Robyn Jones Descendants Trust 2014.
/s/ P. Ryan Langston, as Attorney-in-Fact for Robyn Mary Elizabeth Jones
2023-02-27
/s/ P. Ryan Langston, as Attorney-in-Fact for Mark & Robyn Jones Descendants Trust 2014
2023-02-27
/s/ P. Ryan Langston, as Attorney-in-Fact for Mark Evan Jones
2023-02-27