0001726978-24-000060.txt : 20240703
0001726978-24-000060.hdr.sgml : 20240703
20240703171353
ACCESSION NUMBER: 0001726978-24-000060
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240701
FILED AS OF DATE: 20240703
DATE AS OF CHANGE: 20240703
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Miller Mark
CENTRAL INDEX KEY: 0001737949
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 241100908
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]
ORGANIZATION NAME: 02 Finance
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_1720041227.xml
FORM 4
X0508
4
2024-07-01
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737949
Miller Mark
1500 SOLANA BLVD
BUILDING 4, SUITE 4500
WESTLAKE
TX
76262
1
1
0
0
President and CEO
0
Employee Stock Options (right to buy)
61.35
2024-07-01
4
A
0
50000
0
A
2034-07-01
Class A Common Stock
50000
50000
D
One third (1/3rd) of the shares subject to the option shall vest and become exercisable, subject to continued employment, on each of the first, second and third anniversaries of the grant date; provided that, all shares subject to the option will vest and become exercisable if, within six months following a "change in control" (as defined in the issuer's omnibus incentive plan), Mr. Miller's employment is terminated without "cause" or for "good reason" (each as defined in either Mr. Miller's option award agreement or the issuer's omnibus incentive plan).
/s/ John O'Connor, as Attorney-in-Fact for Mark Miller
2024-07-03