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