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