Adrienne Kebodeaux - 31 Dec 2021 Form 5 Insider Report for Goosehead Insurance, Inc. (GSHD)

Role: Member of 10% owner group, 10%+ Owner
Signature: /s/ P. Ryan Langston, as Attorney-in-Fact for Adrienne Jones
Issuer symbol: GSHD
Transactions as of: 31 Dec 2021
Net transactions value: $0
Form type: 5
Filing time: 14 Feb 2022, 14:31:01 UTC
Next filing: 04 Aug 2022
SEC: View on sec.gov

Transactions Table

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Ownership	Footnotes
transaction	GSHD	Class B Common Stock	Gift	$0	-78,530	-16%	$0.000000	408,027	21 Dec 2021	Direct	F1
transaction	GSHD	Class B Common Stock	Gift	$0	+78,530		$0.000000	78,530	21 Dec 2021	Chick and The Bear Irrevocable Trust	F1

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type	Sym	Class	Transaction	Value $	Shares	Change %	* Price $	Shares After	Date	Underlying Class	Amount	Exercise Price	Ownership	Footnotes
transaction	GSHD	LLC Units in Goosehead Financial, LLC	Gift	$0	-78,530	-16%	$0.000000	408,027	21 Dec 2021	Class A Common Stock	78,530	$0.000000	Direct	F2
transaction	GSHD	LLC Units in Goosehead Financial, LLC	Gift	$0	+78,530		$0.000000	78,530	21 Dec 2021	Class A Common Stock	78,530	$0.000000	Chick and The Bear Irrevocable Trust	F2

* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id	Content
F1	This transaction involved a gift of securities by the reporting person to Chick & The Bear Irrevocable Trust.
F2	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.