0001726978-23-000052.txt : 20230504
0001726978-23-000052.hdr.sgml : 20230504
20230504215946
ACCESSION NUMBER: 0001726978-23-000052
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230502
FILED AS OF DATE: 20230504
DATE AS OF CHANGE: 20230504
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: 23891015
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_168325197053897.xml
FORM 4
X0407
4
2023-05-02
0
0001726978
Goosehead Insurance, Inc.
GSHD
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
0
Director Stock Options (right to buy)
58.0
2023-05-02
4
A
0
15000
0
A
2033-05-02
Class A Common Stock
15000.0
15000
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 Robyn Mary Elizabeth Jones
2023-05-04