SEC Form 4 · accession 0001726978-18-000026
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Camille Peterson
10% Owner · Other
Period of report
Nov 26, 2018
Accepted (ET)
Nov 27, 2018 · 4:56 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 Stock | Nov 26, 2018 | C | 3,100 | $24.927 | D | 495,457 | D | |
| Class A Common Stock | Nov 26, 2018 | C | 3,100 | $24.927 | A | 3,100 | D | |
| Class A Common Stock | Nov 26, 2018 | S | 3,100 | $24.927 | D | 0 | 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 | $0.00 | Nov 26, 2018 | C | 3,100 | D | — | — | Class A Common Stock | 3,100 | 495,457 | D |
Explanation of responses
- F1Each 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.