Form Type: 4

SEC EDGAR Link
Accession Number:0001726978-21-000087
Date:2021-05-12
Issuer: GOOSEHEAD INSURANCE, INC. (GSHD)
Original Submission Date:

Reporting Person:

JONES ROBYN MARY ELIZABETH
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BUILDING 4, STE 4500 WESTLAKE, TX 76262

Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
Title of SecurityTransaction Date2a. Deemed Execution Date Transaction CodeSharesAcquired or DisposedPrice per share 5. Amount of Securities Beneficially Owned Following Reported Transaction 6. Ownership Form Direct or IndirectNature of Indirect Ownership
CLASS B COMMON STOCK 2021-05-12 C 15,584 d $0.00 132,349 direct
CLASS A COMMON STOCK 2021-05-12 C 15,584 a $0.00 349,374 direct
CLASS A COMMON STOCK 2021-05-12 S 2,499 d $91.18 346,875 direct
CLASS A COMMON STOCK 2021-05-12 S 10,277 d $92.14 336,598 direct
CLASS A COMMON STOCK 2021-05-12 S 2,808 d $92.90 333,790 direct
CLASS B COMMON STOCK 2021-05-12 0 $0.00 12,528,282 indirect f5
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, convertible securities
Title of Derivative Security Conversion or Exercise Price of Derivative Security Transaction Date Deemed Execution Date Transaction Code Number of Derivative Securities Acquired (A) or Disposed of (D) Date ExercisableExpiration Date Title and Amount of Securities Underlying Derivative Security Price of Derivative Security Number of derivative Securities Beneficially Owned Following Reported Transaction(s) Ownership Form: Direct (D) or Indirect (I) Nature of Indirect Beneficial Ownership
LLC UNITS IN GOOSEHEAD FINANCIAL, LLC 0.0 2021-05-12 deemed execution date C 15,584 (d) class a common stock 15,584 $0.00 132,349 direct
LLC UNITS IN GOOSEHEAD FINANCIAL, LLC 0.0 2021-05-12 deemed execution date 0 ( ) class a common stock 12,528,282 $0.00 12,528,282 indirect by trust
Footnotes
IDfootnote
f1 this does not reflect shares directly held by the reporting person's spouse, who is independently a reporting person of the issuer.
f2 the price reported in column 4 is a weighted average price. these shares were sold in multiple transactions at prices ranging from $92.99 to $93.99, 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.
f3 the price reported in column 4 is a weighted average price. these shares were sold in multiple transactions at prices ranging from $94.00 to $95.00, 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.
f4 the price reported in column 4 is a weighted average price. these shares were sold in multiple transactions at prices ranging from $95.01 to $96.01, 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.
f5 reflects 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.
f6 each 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.
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