SEC Form 4 · accession 0001726978-18-000031
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew Colby
Officer — Vice President of Agency Sales
Period of report
Nov 28, 2018
Accepted (ET)
Nov 30, 2018 · 6:39 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 | 2,500 | $0.00 | D | 92,444 | D | |
| Class A Common Stock | Nov 28, 2018 | C | 2,500 | $0.00 | A | 2,500 | D | |
| Class A Common Stock | Nov 28, 2018 | S | 2,500 | $25.00 | 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,F2 | $0.00 | Nov 28, 2018 | C | 2,500 | D | — | — | Class A Common Stock | 2,500 | 92,444 | D |
Explanation of responses
- F1Reflects 94,944 shares of Class B Common Stock and LLC Units received pursuant to a pro rata distribution from Texas Wasatch Insurance Partners, LP.
- 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.