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

Signature
/s/ P. Ryan Langston, as Attorney-in-Fact for Adrienne Jones
Stock symbol
GSHD
Transactions as of
Dec 31, 2021
Transactions value $
$0
Form type
5
Date filed
2/14/2022, 02:31 PM
Next filing
Aug 4, 2022

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction GSHD Class B Common Stock Gift $0 -78.5K -16.14% $0.00 408K Dec 21, 2021 Direct F1
transaction GSHD Class B Common Stock Gift $0 +78.5K $0.00 78.5K Dec 21, 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 -78.5K -16.14% $0.00 408K Dec 21, 2021 Class A Common Stock 78.5K $0.00 Direct F2
transaction GSHD LLC Units in Goosehead Financial, LLC Gift $0 +78.5K $0.00 78.5K Dec 21, 2021 Class A Common Stock 78.5K $0.00 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.