0001628280-24-024607.txt : 20240521 0001628280-24-024607.hdr.sgml : 20240521 20240521182421 ACCESSION NUMBER: 0001628280-24-024607 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: Steele Barry G CENTRAL INDEX KEY: 0001305741 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 24971133 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] 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_1716330252.xml FORM 4 X0508 4 2024-05-17 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 61355 D Common Stock 2024-05-17 4 A 0 3886 0 A 65241 D Common Stock 2024-05-17 4 F 0 1811 6.44 D 63430 D Common Stock 2024-05-18 4 M 0 7051 0 A 70481 D Common Stock 2024-05-18 4 F 0 3286 6.44 D 67195 D Common Stock 2024-05-20 4 P 0 3000 6.4661 A 70195 D Restricted Stock Units 0 2024-05-17 4 A 0 20702 0 A 2027-05-17 2027-05-17 Common Stock 20702 20702 D Stock Option (right to buy) 6.34 2024-05-17 4 A 0 93674 0 A 2034-05-17 Common Stock 93674 93674 D Restricted Stock Units 2024-05-18 4 M 0 7051 0 D Common Stock 7051 0 D This total includes an additional 2,949 shares acquired recently through the Company's Employee Stock Purchase Plan On May 17, 2024, 3,886 performance-based restricted stock units, granted on May 17, 2022, vested Represents the withholding of the Issuer's common stock for the tax liability associated with the vesting and settlement of the common stock issued on May 17, 2024 Represents the withholding of the Issuer's common stock for the tax liability associated with the vesting and settlement of the common stock issued on May 18, 2024 The price reported in Column 4 is a weighted average price. These shares reported herein were purchased in multiple transactions. The reporting person undertakes to provide to the Issuer, and security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price. Restricted stock units convert into common stock on a one-for-one basis. The option, representing the right to purchase a total of 93,674 shares of InfuSystem Holdings, Inc. common stock, vests in four equal annual installments beginning May 17, 2025. These restricted stock units will cliff vested on May 18, 2024. /s/ Kevin Whitman, Attorney-in-Fact for Barry G. Steele 2024-05-21