Form Type: 4

SEC EDGAR Link
Accession Number:0001726978-21-000112
Date:2021-05-28
Issuer: GOOSEHEAD INSURANCE, INC. (GSHD)
Original Submission Date:

Reporting Person:

BURKS DREW
C/O GOOSEHEAD INSURANCE, INC.
1500 SOLANA BLVD., BLDG 4, SUITE 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 A COMMON STOCK 2021-05-28 M 1,000 a $10.00 1,039 direct
CLASS A COMMON STOCK 2021-05-28 S 1,000 d $90.69 39 direct
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
EMPLOYEE STOCK OPTIONS 10.0 2021-05-28 deemed execution date M 1,000 (d) 2028-04-26 class a stock 1,000 $10.00 34,500 direct
Footnotes
IDfootnote
f1 one third (1/3rd) of the shares subject to the option shall vest and become exercisable, subject to continued employment, on each of the second, third and fourth anniversaries of the grant date; provided, that all shares subject to the option will vest and become exercisable if mr. burks' employment is terminated without "cause" or for "good reason" (each as defined in either mr. burks' option award agreement or the issuer's omnibus incentive plan) within six month following a "change in control" (as defined in the issuer's omnibus incentive plan).

Elevate your investments