0001726978-22-000015.txt : 20220214
0001726978-22-000015.hdr.sgml : 20220214
20220214153029
ACCESSION NUMBER: 0001726978-22-000015
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211231
FILED AS OF DATE: 20220214
DATE AS OF CHANGE: 20220214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Colby Michael C.
CENTRAL INDEX KEY: 0001737258
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38466
FILM NUMBER: 22630541
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
5
1
wf-form5_164487060829963.xml
FORM 5
X0306
5
2021-12-31
0
0
0
0001726978
Goosehead Insurance, Inc.
GSHD
0001737258
Colby Michael C.
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500
WESTLAKE
TX
76262
0
1
0
0
President and COO
Class A Common Stock
2022-01-11
5
G
0
250
0
D
22881
D
Class A Common Stock
2022-01-11
5
G
0
250
0
D
22631
D
Class A Common Stock
83402
I
By Colby 2014 Family Trust
This transaction involved two equal gifts of securities by the reporting person. The total holdings reflected in the Forms 4 filed by the reporting person subsequent the date of the gifts reported hereby will be reduced to reflect such gifts.
/s/ P. Ryan Langston, as Attorney-in-Fact for Michael C. Colby
2022-02-14