0001014108-22-000026.txt : 20220124
0001014108-22-000026.hdr.sgml : 20220124
20220124202225
ACCESSION NUMBER: 0001014108-22-000026
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220120
FILED AS OF DATE: 20220124
DATE AS OF CHANGE: 20220124
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Dilorio Richard
CENTRAL INDEX KEY: 0001706994
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35020
FILM NUMBER: 22550885
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: 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
2022-01-20
0
0001337013
InfuSystem Holdings, Inc
INFU
0001706994
Dilorio Richard
3851 WEST HAMLIN ROAD
ROCHESTER HILL
MI
48309
1
1
0
0
President & CEO
Common Stock
2022-01-20
4
M
0
15936
1.98
A
255771
D
Common Stock
2022-01-20
4
S
0
15936
15.98
D
239835
D
Common Stock
2022-01-21
4
M
0
9064
1.98
A
248899
D
Common Stock
2022-01-21
4
S
0
9064
15.52
D
239835
D
Common Stock
2022-01-21
4
M
0
149
2
A
239984
D
Common Stock
2022-01-21
4
S
0
149
15.52
D
239835
D
Common Stock
2022-01-24
4
M
0
33519
2
A
273354
D
Common Stock
2022-01-24
4
S
0
33519
15.41
D
239835
D
Stock Option (right to buy)
1.98
2022-01-20
4
M
0
15936
0
D
2018-09-07
2022-09-07
Common Stock
15936
9064
D
Stock Option (right to buy)
1.98
2022-01-21
4
M
0
9064
0
D
2018-09-07
2022-09-07
Common Stock
9064
0
D
Stock Option (right to buy)
2
2022-01-21
4
M
0
149
0
D
2017-12-15
2022-11-15
Common Stock
149
199851
D
Stock Option (right to buy)
2
2022-01-24
4
M
0
33519
0
D
2017-12-15
2022-11-15
Common Stock
33519
166332
D
This total includes 78 shares acquired recently through the Company's Employee Stock Purchase Plan.
The transactions reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan previously adopted by the reporting person.
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 Richard Dilorio
2022-01-24