SEC Form 4 · accession 0001726978-18-000029
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael C. Colby
Officer — President and COO
Period of report
Nov 28, 2018
Accepted (ET)
Nov 29, 2018 · 7:49 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 28, 2018 | C | 22,000 | $0.00 | D | 1,007,024 | D | |
| Class A Common Stock | Nov 28, 2018 | C | 22,000 | $0.00 | A | 114,631 | D | |
| Class A Common StockF2 | Nov 28, 2018 | S | 20,348 | $25.38 | D | 94,283 | D | |
| Class A Common StockF3 | Nov 29, 2018 | S | 1,652 | $25.37 | D | 92,631 | D | |
| Class B Common StockF4 | holding | — | — | — | 858,166 | I | By Trust | |
| Class A Common Stock | holding | — | — | — | 238,402 | I | By Colby 2014 Family Trust |
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,F5 | $0.00 | Nov 28, 2018 | C | 22,000 | D | — | — | Class A Common Stock | 22,000 | 1,007,024 | D |
| LLC Units in Goosehead Financial, LLCF4,F5 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 858,166 | 858,166 | I |
Explanation of responses
- F1Includes 61,939 shares of Class B Common Stock or LLC Units, as applicable, as a pro rata distribution from Texas Wasatch InsurancePartners, LP.
- F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $25.31 to $25.55, inclusive. The reporting person undertakes to provide to the issuer, any security holder of the issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the range set forth in footnotes (2) and (3) to this Form 4.
- F3The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $25.13 to $25.64, inclusive.
- F4Reflects shares of Class A Common Stock, shares of Class B Common Stock or LLC Units, as applicable, held in trust for which the reporting person serves as a trustee and of which immediate family members of the reporting person are beneficiaries.
- F5Each 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.