0001014108-21-000208.txt : 20211202
0001014108-21-000208.hdr.sgml : 20211202
20211202191056
ACCESSION NUMBER: 0001014108-21-000208
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211130
FILED AS OF DATE: 20211202
DATE AS OF CHANGE: 20211202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lehman Gregg Owen
CENTRAL INDEX KEY: 0001376620
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 211468275
MAIL ADDRESS:
STREET 1: 309 HADDON COURT
CITY: FRANKLIN
STATE: X1
ZIP: 37067
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: 3851 WEST HAMLIN ROAD
CITY: ROCHESTER HILLS
STATE: MI
ZIP: 48309
BUSINESS PHONE: (248) 291-1210
MAIL ADDRESS:
STREET 1: 3851 WEST HAMLIN ROAD
CITY: ROCHESTER HILLS
STATE: MI
ZIP: 48309
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
2021-11-30
0
0001337013
InfuSystem Holdings, Inc
INFU
0001376620
Lehman Gregg Owen
3851 WEST HAMLIN ROAD
ROCHESTER HILL
MI
48309
1
0
0
0
Common Stock
2021-11-30
4
M
0
1292
2.39
A
1638
D
Common Stock
2021-11-30
4
S
0
1292
17.03
D
346
D
Common Stock
2021-12-01
4
M
0
2645
2.39
A
2991
D
Common Stock
2021-12-01
4
S
0
2645
16.18
D
346
D
Common Stock
2021-12-02
4
M
0
255
2.39
A
601
D
Common Stock
2021-12-02
4
S
0
255
16.01
D
346
D
Stock Option (right to buy)
2.39
2021-11-30
4
M
0
1292
0
D
2017-02-18
2022-01-18
Common Stock
1292
8708
D
Stock Option (right to buy)
2.39
2021-12-01
4
M
0
2645
0
D
2017-02-18
2022-01-18
Common Stock
2645
6063
D
Stock Option (right to buy)
2.39
2021-12-02
4
M
0
255
0
D
2017-02-18
2022-01-18
Common Stock
255
5808
D
The price reported in Column 4 is a weighted average price. These shares reported herein were sold in multiple transactions. The reporting person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price.
/s/ Kevin Whitman, Attorney-in-Fact for Gregg O. Lehman
2021-12-02