0001014108-21-000027.txt : 20210211 0001014108-21-000027.hdr.sgml : 20210211 20210211204613 ACCESSION NUMBER: 0001014108-21-000027 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210209 FILED AS OF DATE: 20210211 DATE AS OF CHANGE: 20210211 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Steele Barry G CENTRAL INDEX KEY: 0001305741 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 21622101 MAIL ADDRESS: STREET 1: 500 TOWN CENTER DR., SUITE 200 CITY: DEARBORN STATE: MI ZIP: 48126 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: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 BUSINESS PHONE: (248) 291-1210 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-02-09 0 0001337013 InfuSystem Holdings, Inc INFU 0001305741 Steele Barry G 3851 WEST HAMLIN ROAD ROCHESTER HILLS MI 48309 0 1 0 0 Executive VP and CFO Common Stock 2021-02-09 4 A 0 2678 0 A 19659 D The reported shares were issued as part of the issuer's Short Term Incentive ("STI") plan relating to the issuer's 2020 performance. The issuer's board of directors decided that a portion of the award determined payable to the issuer's executive team would be payable in the form of fully-vested shares of the issuer's common stock. Such shares are issued under the issuer's 2014 Equity Plan. /s/Kevin Whitman, Attorney-in-Fact for Barry G. Steele 2021-02-11