SEC Form 4 · accession 0001726978-18-000024
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robyn Mary Elizabeth Jones
Director · 10% Owner · Other
Period of report
Nov 13, 2018
Accepted (ET)
Nov 15, 2018 · 3:23 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001726978
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class B Common StockF1 | Nov 13, 2018 | C | 1,817 | $27.0285 | D | 15,188,926 | I | By Mark and Robyn Jones Descendants Trust 2014 |
| Class A Common StockF1 | Nov 13, 2018 | C | 1,817 | $27.0285 | A | 1,750,098 | I | By Mark and Robyn Jones Descendants Trust 2014 |
| Class A Common StockF1 | Nov 13, 2018 | S | 1,817 | $27.0285 | D | 1,748,281 | I | By Mark and Robyn Jones Descendants Trust 2014 |
| Class A Common Stock | holding | — | — | — | 757,890 | D | ||
| Class B Common Stock | holding | — | — | — | 171,633 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| LLC Units in Goosehead Financial, LLCF1,F2 | $0.00 | Nov 13, 2018 | C | 1,817 | D | — | — | Class A Common Stock | 1,817 | 15,188,926 | I |
| LLC Units in Goosehead Financial, LLCF2 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 171,633 | 171,633 | D |
Explanation of responses
- F1Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, and held in trust for which the reporting person serves as trustee and of which immediate family members of the reporting person are beneficiaries.
- F2Each 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.
Remarks
The sales reported were effected pursuant to a Rule 10b5-1 trading plan adopted by the Mark and Robyn Jones Descendants Trust 2014.