0001726978-23-000057.txt : 20230508 0001726978-23-000057.hdr.sgml : 20230508 20230508164521 ACCESSION NUMBER: 0001726978-23-000057 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230505 FILED AS OF DATE: 20230508 DATE AS OF CHANGE: 20230508 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: 23898427 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: 23898426 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: 23898428 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_168357870386817.xml FORM 4 X0407 4 2023-05-05 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 1 Class B Common Stock 2023-05-05 4 C 0 13134 0 D 8469240 D Class A Common Stock 2023-05-05 4 C 0 13134 0 A 13134 D Class A Common Stock 2023-05-05 4 S 0 13134 60.03 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 2023-05-05 4 C 0 13134 0 D Class A Common Stock 13134.0 8469240 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. 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 $60.20, 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 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. /s/ P. Ryan Langston, as Attorney-in-Fact for Robyn Mary Elizabeth Jones 2023-05-08 /s/ P. Ryan Langston, as Attorney-in-Fact for Mark & Robyn Jones Descendants Trust 2014 2023-05-08 /s/ P. Ryan Langston, as Attorney-in-Fact for Mark Evan Jones 2023-05-08