SEC Form 4 · accession 0001726978-19-000002
Goosehead Insurance, Inc. · GSHD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark Evan Jones
Officer — CEO · Director · 10% Owner · Other
Period of report
Dec 31, 2018
Accepted (ET)
Jan 2, 2019 · 6:02 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 31, 2018 | C | 309 | $0.00 | D | 14,989,595 | I | By Trust |
| Class A Common Stock | Dec 31, 2018 | C | 309 | $0.00 | A | 1,748,590 | I | By Mark and Robyn Jones Descendants Trust 2014 |
| Class A Common Stock | Dec 31, 2018 | S | 309 | $27.00 | D | 1,748,281 | I | By Mark and Robyn Jones Descendants Trust 2014 |
| Class B Common StockF2,F3 | holding | — | — | — | 182,349 | D | ||
| Class A Common StockF3 | holding | — | — | — | 749,317 | 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,F4 | $0.00 | Dec 31, 2018 | C | 309 | D | — | — | Class A Common Stock | 309 | 14,989,595 | I |
| LLC Units in Goosehead Financial, LLCF2,F3,F4 | $0.00 | holding | — | — | — | — | — | Class A Common Stock | 182,349 | 182,349 | D |
Explanation of responses
- F1Reflects 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.
- F2Includes 10,716 shares of Class B Common Stock or LLC Units, as applicable, as a pro rata distribution from Texas Wasatch Insurance Partners, LP.
- F3This does not reflect shares directly held by the reporting person's spouse, who is independently a reporting person of the issuer.
- F4Each 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
The sales reported were effected pursuant to a Rule 10b5-1 trading plan adopted by the Mark and Robyn Jones Descendants Trust 2014.