0001628280-24-024609.txt : 20240521 0001628280-24-024609.hdr.sgml : 20240521 20240521182643 ACCESSION NUMBER: 0001628280-24-024609 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240517 FILED AS OF DATE: 20240521 DATE AS OF CHANGE: 20240521 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOYD RALPH F JR CENTRAL INDEX KEY: 0001269702 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 24971143 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: InfuSystem Holdings, Inc CENTRAL INDEX KEY: 0001337013 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] ORGANIZATION NAME: 08 Industrial Applications and Services 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 wk-form4_1716330391.xml FORM 4 X0508 4 2024-05-17 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 Option (right to buy) 6.34 2024-05-17 4 A 0 35685 0 A 2025-05-17 2034-05-17 Common Stock 35685 35685 D The option, representing the right to purchase 35,685 shares of InfuSystem Holdings, Inc. common stock, vests on May 17, 2025. /s/ Kevin Whitman, Attorney-in-Fact for Ralph F. Boyd, Jr. 2024-05-21