SEC Form 4 · accession 0001726978-18-000027
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark S. Colby
Officer — Chief Financial Officer
Period of report
May 1, 2018
Accepted (ET)
Nov 29, 2018 · 10:44 am 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 A Common Stock | May 1, 2018 | P | 1,500 | $10.00 | A | 38,637 | D | |
| Class A Common Stock | Nov 23, 2018 | G | 1,500 | $0.00 | D | 37,137 | D | |
| Class B Common StockF1 | holding | — | — | — | 107,160 | 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 | holding | — | — | — | — | — | Class A Common Stock | 107,160 | 107,160 | D |
Explanation of responses
- F1Reflects the distribution of shares acquired through the dissolution of Texas Wasatch Insurance Partners, LP, which was not a reportable transaction.
- 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.