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