0001628280-22-015218.txt : 20220523 0001628280-22-015218.hdr.sgml : 20220523 20220523170011 ACCESSION NUMBER: 0001628280-22-015218 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20220520 FILED AS OF DATE: 20220523 DATE AS OF CHANGE: 20220523 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Steele Barry G CENTRAL INDEX KEY: 0001305741 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 22952555 MAIL ADDRESS: STREET 1: 500 TOWN CENTER DR., SUITE 200 CITY: DEARBORN STATE: MI ZIP: 48126 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_165333959048536.xml FORM 4 X0306 4 2022-05-20 0 0001337013 InfuSystem Holdings, Inc INFU 0001305741 Steele Barry G C/O INFUSYSTEM HOLDINGS, INC. 3851 WEST HAMLIN ROAD ROCHESTER HILLS MI 48309 0 1 0 0 Executive VP and CFO Common Stock 2022-05-20 4 A 0 7500 0 A 37300 D Common Stock 2022-05-20 4 F 0 3270 8.49 D 34030 D Common Stock 2022-05-20 4 A 0 3525 0 A 37555 D Common Stock 2022-05-20 4 F 0 1537 8.49 D 36018 D On May 20, 2022, 7,500 performance-based restricted stock units, granted on May 20, 2020, 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 20, 2022 On May 20, 2022, 3,525 performance-based restricted stock units, granted on May 20, 2020, vested /s/ Kevin Whitman, Attorney-in-Fact for Barry G. Steele 2022-05-23