0001014108-18-000123.txt : 20180517 0001014108-18-000123.hdr.sgml : 20180517 20180517184108 ACCESSION NUMBER: 0001014108-18-000123 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171120 FILED AS OF DATE: 20180517 DATE AS OF CHANGE: 20180517 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sansone Christopher R. CENTRAL INDEX KEY: 0001519525 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 18844582 MAIL ADDRESS: STREET 1: C/O SANSONE ADVISORS, LLC STREET 2: 151 BODMAN PLACE, SUITE 100 CITY: RED BANK STATE: NJ ZIP: 07701 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/A 1 primary_doc.xml PRIMARY DOCUMENT X0306 4/A 2017-11-20 2017-11-22 0 0001337013 InfuSystem Holdings, Inc INFU 0001519525 Sansone Christopher R. C/O INFUSYSTEM HOLDINGS, INC. 31700 RESEARCH PARK DRIVE MADISON HEIGHTS MI 48071 1 0 0 0 Common Stock 0 D Common Stock 2017-11-20 4 P 0 28148 2.0401 A 1256079 I See Common Stock 2017-11-21 4 P 0 15327 2.1916 A 1271406 I See Common Stock 2017-11-20 4 P 0 7037 2.0401 A 262654 I See Common Stock 2017-11-21 4 P 0 3832 2.1916 A 266486 I See In the Reporting Person's Form 4 report filed with the Commission on November 22, 2017, and in each of the four Form 4 reports filed by the Reporting Person subsequent to that November 22, 2017 Form 4 filing, the Reporting Person mistakenly reported the securities owned by Sansone Partners, L.P. (see footnote 2 below) and by Sansone Partners (QP), L.P. (see footnote 3 below) as being owned by him directly in addition to also being reported as being owned by him indirectly. That November 22, 2017 Form 4 filing, and the four subsequent Form 4 filings, are amended to clarify that the Reporting Person owned no shares directly and to correctly report the actual indirect ownership of shares and thereby eliminates the duplicative reporting of shares. The reported securities are directly owned by Sansone Partners, L.P., a Delaware limited partnership. The Reporting Person is the managing member of (i) the general partner of this limited partnership and (ii) the investment manager of this limited partnership and, as such, may be deemed to indirectly beneficially own the shares held by this limited partnership. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The reported securities are directly owned by Sansone Partners (QP), L.P., a Delaware limited partnership. The Reporting Person is the managing member of (i) the general partner of this limited partnership and (ii) the investment manager of this limited partnership and, as such, may be deemed to indirectly beneficially own the shares held by this limited partnership. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/Trent N. Smith, Attorney-in-Fact for Christopher R. Sansone 2018-05-17