0001628280-23-008630.txt : 20230320 0001628280-23-008630.hdr.sgml : 20230320 20230320172056 ACCESSION NUMBER: 0001628280-23-008630 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20230318 FILED AS OF DATE: 20230320 DATE AS OF CHANGE: 20230320 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: 23747167 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_167934724570491.xml FORM 4 X0407 4 2023-03-18 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 0 Common Stock 2023-03-18 4 M 0 30000 0 A 66552 D Common Stock 2023-03-18 4 F 0 13352 6.90 D 53200 D Restricted Stock Units 0.0 2023-03-18 4 M 0 30000 0 D 2023-03-18 Common Stock 30000.0 0 D This total includes an additional 534 shares acquired recently through the Company's Employee Stock Purchase Plan 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 March 18, 2023 Restricted stock units convert into common stock on a one-for-one basis. These restricted stock units vested on March 18, 2023. /s/ Kevin Whitman, Attorney-in-Fact for Barry G. Steele 2023-03-20