0001437749-19-008279.txt : 20190430 0001437749-19-008279.hdr.sgml : 20190430 20190430134832 ACCESSION NUMBER: 0001437749-19-008279 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190422 FILED AS OF DATE: 20190430 DATE AS OF CHANGE: 20190430 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sheehan Jeannine CENTRAL INDEX KEY: 0001775188 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 19780347 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 rdgdoc.xml FORM 4 X0306 4 2019-04-22 0001337013 InfuSystem Holdings, Inc INFU 0001775188 Sheehan Jeannine 31700 RESEARCH PARK DRIVE MADISON HEIGHTS MI 48071 1 CHIEF ADMINISTRATIVE OFFICER Stock Option (Right to Buy) 4.48 2019-04-22 4 A 0 50000 0 A 2024-04-22 Common Stock 50000 50000 D The option, representing the right to purchase a total of 50,000 shares of InfuSystem Holdings, Inc. common stock, vests annually over three years beginning April 22, 2020. /s/ Jeannine Sheehan 2019-04-30