0001628280-23-019113.txt : 20230519
0001628280-23-019113.hdr.sgml : 20230519
20230519165947
ACCESSION NUMBER: 0001628280-23-019113
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230518
FILED AS OF DATE: 20230519
DATE AS OF CHANGE: 20230519
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BOYD RALPH F JR
CENTRAL INDEX KEY: 0001269702
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 23941224
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: InfuSystem Holdings, Inc
CENTRAL INDEX KEY: 0001337013
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
IRS NUMBER: 203341405
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 3851 WEST HAMLIN ROAD
CITY: ROCHESTER HILLS
STATE: MI
ZIP: 48309
BUSINESS PHONE: (248) 291-1210
MAIL ADDRESS:
STREET 1: 3851 WEST HAMLIN ROAD
CITY: ROCHESTER HILLS
STATE: MI
ZIP: 48309
FORMER COMPANY:
FORMER CONFORMED NAME: HAPC, Inc.
DATE OF NAME CHANGE: 20060425
FORMER COMPANY:
FORMER CONFORMED NAME: Healthcare Acquisition Partners Corp.
DATE OF NAME CHANGE: 20050824
4
1
wf-form4_168452996925718.xml
FORM 4
X0407
4
2023-05-18
0
0001337013
InfuSystem Holdings, Inc
INFU
0001269702
BOYD RALPH F JR
3851 WEST HAMLIN ROAD
ROCHESTER HILLS
MI
48309
1
0
0
0
0
Common Stock
2000
D
Stock Options (right to buy)
9.18
2023-05-18
4
A
0
24424
0
A
2024-05-18
2033-05-18
Common Stock
24424.0
24424
D
The option, representing the right to purchase a total of 24,424 shares of InfuSystem Holdings, Inc. common stock, vests on May 18, 2024.
/s/ Kevin Whitman, Attorney-in-Fact for Ralph F. Boyd, Jr.
2023-05-19