Filing Details
- Accession Number:
- 0001628280-24-024592
- Form Type:
- 4
- Zero Holdings:
- No
- Publication Time:
- 2024-05-21 18:14:28
- Reporting Period:
- 2024-05-17
- Accepted Time:
- 2024-05-21 18:14:28
- SEC Url:
- Form 4 Filing
Issuer
| Cik | Name | Symbol | Sector (SIC) | IRS No |
|---|---|---|---|---|
| 1337013 | Infusystem Holdings Inc | INFU | Surgical & Medical Instruments & Apparatus (3841) | 203341405 |
Insiders
| Cik | Name | Reported Address | Insider Title | Director | Officer | Large Shareholder | Other |
|---|---|---|---|---|---|---|---|
| 1953233 | Addam Chupa | C/O Infusystem Holdings, Inc. 3851 West Hamlin Road Rochester Hills MI 48309 | Executive Vp And Cio | No | Yes | No | No |
Reported Non-Derivative Transactions
| Sec. Name | Acquisiton - Disposition | Date | Amount | Price | Remaning Holdings | Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|---|---|---|---|---|---|
| Common Stock | Acquisiton | 2024-05-17 | 2,850 | $0.00 | 24,761 | No | 4 | A | Direct | |
| Common Stock | Disposition | 2024-05-17 | 987 | $6.44 | 23,774 | No | 4 | F | Direct | |
| Common Stock | Acquisiton | 2024-05-21 | 1,000 | $6.67 | 24,774 | No | 4 | P | Direct |
| Equity Swap Involved | Form Type | Code | Nature of Ownership | Explanation |
|---|---|---|---|---|
| No | 4 | A | Direct | |
| No | 4 | F | Direct | |
| No | 4 | P | Direct |
Reported Derivative Transactions
| Sec. Name | Sec. Type | Acquisiton - Disposition | Date | Amount | Price | Amount - 2 | Price - 2 |
|---|---|---|---|---|---|---|---|
| Common Stock | Restricted Stock Units | Acquisiton | 2024-05-17 | 11,830 | $0.00 | 11,830 | $0.00 |
| Common Stock | Stock Option (right to buy) | Acquisiton | 2024-05-17 | 53,528 | $0.00 | 53,528 | $6.34 |
| Remaning Holdings | Exercise Date | Expiration Date | Equity Swap Involved | Transaction Form Type | Transaction Code | Nature of Ownership |
|---|---|---|---|---|---|---|
| 11,830 | 2027-05-17 | 2027-05-17 | No | 4 | A | Direct |
| 53,528 | 2034-05-17 | No | 4 | A | Direct |
Reported Non-Derivative Holdings
| Sec. Name | Remaning Holdings | Nature of Ownership | Explanation |
|---|---|---|---|
| Common Stock | 21,911 | Direct |
Footnotes
- This total includes an additional 892 shares acquired recently through the Company's Employee Stock Purchase Plan
- On May 17, 2024, 2,850 performance-based restricted stock units, granted on May 17, 2022, vested
- Represents the withholding of the Issuer's common stock for the tax liability associated with the vesting and settlement of the common stock issued on May 17, 2024
- 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.
- Restricted stock units convert into common stock on a one-for-one basis.
- The option, representing the right to purchase a total of 53,528 shares of InfuSystem Holdings, Inc. common stock, vests in four equal annual installments beginning May 17, 2025.
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