0001726978-23-000121.txt : 20230831
0001726978-23-000121.hdr.sgml : 20230831
20230831171835
ACCESSION NUMBER: 0001726978-23-000121
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230830
FILED AS OF DATE: 20230831
DATE AS OF CHANGE: 20230831
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Jones Serena
CENTRAL INDEX KEY: 0001737783
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 231229528
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
wk-form4_1693516685.xml
FORM 4
X0508
4
2023-08-30
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737783
Jones Serena
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BLDG 4, STE 4500
WESTLAKE
TX
76262
0
0
1
1
Member of 10% owner group
0
Class B Common Stock
2023-08-30
4
C
0
73000
0
D
370442
D
Class A Common Stock
2023-08-30
4
C
0
73000
0
A
73000
D
Class A Common Stock
2023-08-30
4
S
0
72800
68.19
D
200
D
Class A Common Stock
2023-08-30
4
S
0
200
69.09
D
0
D
Class B Common Stock
179246
I
SLJ Dynasty Trust
Class B Common Stock
161094
I
SLJ 2023 Grantor Retained Annuity Trust
LLC Units in Goosehead Financial, LLC
0
2023-08-30
4
C
0
73000
0
D
Class A Common Stock
73000
370442
D
LLC Units in Goosehead Financial, LLC
0
Class A Common Stock
179246
179246
I
SLJ Dynasty Trust
LLC Units in Goosehead Financial, LLC
0
Class A Common Stock
161094
161094
I
SLJ 2023 Grantor Retained Annuity Trust
The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $68.00 to $68.99, 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/ John O'Connor, as Attorney-in-Fact for Serena Jones
2023-08-31