0001628280-23-019360.txt : 20230522
0001628280-23-019360.hdr.sgml : 20230522
20230522202714
ACCESSION NUMBER: 0001628280-23-019360
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20230518
FILED AS OF DATE: 20230522
DATE AS OF CHANGE: 20230522
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: 23946266
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: 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_168480162215450.xml
FORM 4
X0407
4
2023-05-18
0
0001337013
InfuSystem Holdings, Inc
INFU
0001305741
Steele Barry G
C/O INFUSYSTEM HOLDINGS, INC.
3851 WEST HAMLIN ROAD
ROCHESTER HILLS
MI
48309
0
1
0
0
Executive VP and CFO
0
Common Stock
58406
D
Stock Options (right to buy)
9.18
2023-05-18
4
A
0
58618
0
A
2033-05-18
Common Stock
58618.0
58618
D
Restricted Stock Units
2023-05-18
4
A
0
8715
0
A
2026-05-18
Common Stock
8715.0
8715
D
This total includes an additional 2,206 shares acquired recently through the Company's Employee Stock Purchase Plan
The option, representing the right to purchase a total of 58,618 shares of InfuSystem Holdings, Inc. common stock, vests in three equal annual installments beginning May 18, 2024.
Restricted stock units convert into common stock on a one-for-one basis.
These restricted stock units will fully vest on May 18, 2026.
/s/ Kevin Whitman, Attorney-in-Fact for Barry G. Steele
2023-05-22