0001014108-21-000031.txt : 20210211 0001014108-21-000031.hdr.sgml : 20210211 20210211211519 ACCESSION NUMBER: 0001014108-21-000031 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210209 FILED AS OF DATE: 20210211 DATE AS OF CHANGE: 20210211 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Whitman Kevin CENTRAL INDEX KEY: 0001768114 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 21622177 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 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 2021-02-09 0 0001337013 InfuSystem Holdings, Inc INFU 0001768114 Whitman Kevin 3851 WEST HAMLIN ROAD ROCHESTER HILLS MI 48309 0 1 0 0 VP and Corporate Controller Restricted Stock Units 2021-02-09 4 A 0 1500 0 A Common Stock 1500 1500 D Stock Option (right to buy) 18.44 2021-02-09 4 A 0 1500 0 A 2031-02-09 Common Stock 1500 1500 D Restricted stock units convert into common stock on a one-for-one basis. These restricted stock units will fully vest on February 9, 2024. The stock option vests 33% per year on the anniversary date of the grant beginning February 9, 2022. /s/Kevin Whitman 2021-02-11