0001628280-23-008632.txt : 20230320 0001628280-23-008632.hdr.sgml : 20230320 20230320172300 ACCESSION NUMBER: 0001628280-23-008632 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230317 FILED AS OF DATE: 20230320 DATE AS OF CHANGE: 20230320 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lachance Carrie CENTRAL INDEX KEY: 0001790024 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 23747187 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 wf-form4_167934737008956.xml FORM 4 X0407 4 2023-03-17 0 0001337013 InfuSystem Holdings, Inc INFU 0001790024 Lachance Carrie C/O INFUSYSTEM HOLDINGS, INC. 3851 WEST HAMLIN ROAD ROCHESTER HILLS MI 48309 1 1 0 0 President and COO 0 Common Stock 2023-03-17 4 P 0 3000 6.8165 A 127939 D The price reported in Column 4 is a weighted average price. These shares reported herein were purchased in multiple transactions. The reporting person undertakes to provide to the Issuer, and security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares purchased at each separate price. /s/ Kevin Whitman, Attorney-in-Fact for Carrie Lachance 2023-03-20