SEC Form 4/A · accession 0001726978-18-000057
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Mark S. Colby
Officer — Chief Financial Officer
Period of report
Dec 17, 2018
Accepted (ET)
Dec 27, 2018 · 5:24 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 | Dec 17, 2018 | C | 1,032 | $0.00 | D | 106,128 | D | |
| Class A Common Stock | Dec 17, 2018 | C | 1,032 | $0.00 | A | 38,169 | D | |
| Class A Common StockF2 | Dec 17, 2018 | S | 1,032 | $27.1842 | D | 37,137 | 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,F3 | $0.00 | Dec 17, 2018 | C | 1,032 | D | — | — | Class A Common Stock | 1,032 | 106,128 | D |
Explanation of responses
- F1Includes 107,160 shares of Class B Common Stock or LLC Units, as applicable, as a pro rata distribution from Texas Wasatch Insurance Partners, LP.
- F2The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $26.72 to $27.39, 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 this footnote to this Form 4.
- F3Each 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
This amended Form 4 is being filed for a discrepancy in the number of shares or LLC Units, as applicable, involved in the reported transactions. The actual number of shares or LLC Units, as applicable, involved in the reported transactions is 1,032 and not 1,302 as previously reported. The sales reported were effected pursuant to a Rule 10b5-1 trading plan adopted by the reporting person.