Goosehead Insurance, Inc. — Director's Dealing 2021

Feb 12, 2021

SEC Form 5 — Annual Statement of Changes in Beneficial Ownership

Issuer: Goosehead Insurance, Inc. (GSHD)
CIK: 0001726978
Period of Report: 2020-12-31

Reporting Person: Romney Lanni (10% Owner, Member of 10% owner group)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2020-11-20	Class B Common Stock	G	88709	—	Disposed	285286	Direct
2020-11-30	Class B Common Stock	G	88704	—	Acquired	88704	Indirect

Derivative Transactions

Date	Security	Exercise Price	Code	Shares	A/D	Expiration	Underlying	Ownership
2020-11-20	LLC Units in Goosehead Financial, LLC	$0.0	G	88709	Disposed		Class A Common Stock (88709.0)	Direct
2020-11-30	LLC Units in Goosehead Financial, LLC	$0.0	G	88704	Acquired		Class A Common Stock (88704.0)	Indirect

Holdings (Non-Derivative)

Security	Shares	Ownership
Class B Common Stock	5	Indirect

Holdings (Derivative)

Security	Exercise Price	Expiration	Underlying	Shares	Ownership
LLC Units in Goosehead Financial, LLC	$0.0		Class A Common Stock (5.0)	5	Indirect

Footnotes

F1: This transaction involved a gift of securities by the reporting person to her husband who is not an affiliate or member of the Amended and Restated Voting Agreement dated September 18, 2020.

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.