0001014108-18-000128.txt : 20180522
0001014108-18-000128.hdr.sgml : 20180522
20180522190040
ACCESSION NUMBER: 0001014108-18-000128
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180518
FILED AS OF DATE: 20180522
DATE AS OF CHANGE: 20180522
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Sansone Christopher R.
CENTRAL INDEX KEY: 0001519525
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 18853613
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
1
primary_doc.xml
PRIMARY DOCUMENT
X0306
4
2018-05-18
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
2018-05-18
4
P
0
583
2.85
A
1396097
I
See
Common Stock
2018-05-21
4
P
0
167
2.85
A
1396264
I
See
Common Stock
2018-05-18
4
P
0
117
2.85
A
293355
I
See
Common Stock
2018-05-21
4
P
0
33
2.85
A
293388
I
See
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
2018-05-22