0001628280-23-005919.txt : 20230301 0001628280-23-005919.hdr.sgml : 20230301 20230301194756 ACCESSION NUMBER: 0001628280-23-005919 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230223 FILED AS OF DATE: 20230301 DATE AS OF CHANGE: 20230301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOYD RALPH F JR CENTRAL INDEX KEY: 0001269702 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 23695904 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_167771805641470.xml FORM 4 X0306 4 2023-02-23 0 0001337013 InfuSystem Holdings, Inc INFU 0001269702 BOYD RALPH F JR 3851 WEST HAMLIN ROAD ROCHESTER HILLS MI 48309 1 0 0 0 Common Stock 2023-02-23 4 A 0 2000 0 A 2000 D Common Stock 2023-02-23 4 M 0 2000 0 D Restricted Stock Units 2000.0 0 D Restricted stock units convert into common stock on a one-for-one basis. These restricted stock units will fully vest on February 23, 2023. /s/ Kevin Whitman, Attorney-in-Fact for Ralph F. Boyd, Jr. 2023-03-01