0001445866-20-000310.txt : 20200331
0001445866-20-000310.hdr.sgml : 20200331
20200331180312
ACCESSION NUMBER: 0001445866-20-000310
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200331
FILED AS OF DATE: 20200331
DATE AS OF CHANGE: 20200331
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shuda Scott
CENTRAL INDEX KEY: 0001486636
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 20763117
MAIL ADDRESS:
STREET 1: 402 RAILROAD AVENUE, SUITE 201
CITY: DANVILLE
STATE: CA
ZIP: 94526
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Meridian TSV II, LP
CENTRAL INDEX KEY: 0001601536
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 20763118
BUSINESS ADDRESS:
STREET 1: 405 WEED STREET
CITY: NEW CANAAN
STATE: CT
ZIP: 06840
BUSINESS PHONE: 203-643-9300
MAIL ADDRESS:
STREET 1: 405 WEED STREET
CITY: NEW CANAAN
STATE: CT
ZIP: 06840
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: TSV Investment Partners, LLC
CENTRAL INDEX KEY: 0001603326
STATE OF INCORPORATION: CT
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 20763119
BUSINESS ADDRESS:
STREET 1: 405 WEED STREET
CITY: NEW CANAAN
STATE: CT
ZIP: 06840
BUSINESS PHONE: 203-643-9300
MAIL ADDRESS:
STREET 1: 405 WEED STREET
CITY: NEW CANAAN
STATE: CT
ZIP: 06840
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BlueLine Capital Partners II, L.P.
CENTRAL INDEX KEY: 0001460781
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 20763120
BUSINESS ADDRESS:
STREET 1: 3480 BUSKIRK AVENUE
STREET 2: SUITE 214
CITY: PLEASANT HILL
STATE: CA
ZIP: 94523
BUSINESS PHONE: 925-236-9790
MAIL ADDRESS:
STREET 1: 3480 BUSKIRK AVENUE
STREET 2: SUITE 214
CITY: PLEASANT HILL
STATE: CA
ZIP: 94523
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: BlueLine Partners, L.L.C.
CENTRAL INDEX KEY: 0001311443
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 20763121
BUSINESS ADDRESS:
STREET 1: 3480 BUSKIRK AVENUE
STREET 2: SUITE 214
CITY: PLEASANT HILL
STATE: CA
ZIP: 94523
BUSINESS PHONE: 925-648-2085
MAIL ADDRESS:
STREET 1: 3480 BUSKIRK AVENUE
STREET 2: SUITE 214
CITY: PLEASANT HILL
STATE: CA
ZIP: 94523
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
2020-03-31
0
0001337013
InfuSystem Holdings, Inc
INFU
0001486636
Shuda Scott
C/O INFUSYSTEM HOLDINGS, INC.,
3851 W. HAMLIN RD,
ROCHESTER HILLS
MI
48309
0
1
1
0
Director
0001601536
Meridian TSV II, LP
405 WEED STREET
NEW CANAAN
CT
06840
0
0
1
0
0001603326
TSV Investment Partners, LLC
405 WEED STREET
NEW CANAAN
CT
06840
0
0
1
0
0001460781
BlueLine Capital Partners II, L.P.
3480 BUSKIRK AVENUE
SUITE 214
PLEASANT HILL
CA
94523
0
0
1
0
0001311443
BlueLine Partners, L.L.C.
3480 BUSKIRK AVENUE
SUITE 214
PLEASANT HILL
CA
94523
0
0
1
0
Common Stock
2020-03-31
4
S
0
169960
8.3698
D
3356561
I
Footnote 1
These securities are owned by Imua T Capital Investments, LLC. The price reported in Column 4 is a weighted average price. These shares reported herein were traded in multiple transactions. The reporting persons undertake to provide to InfuSystem Holdings, Inc., any security holder of InfuSystem Holdings, Inc., or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares traded at each separate price.
Imua T Capital Investments, LLC is a member of the group described in Amendment No. 1 to Schedule 13D filed by Meridian OHC Partners, LP and others on August 31, 2018. Imua T Capital Investments, LLC is managed separately from the other members of such group, and the securities reported transacting herein were all of the shares held by Imua T Capital Investments, LLC.
/s/ Scott Shuda
2020-03-31