0001014108-19-000136.txt : 20190820 0001014108-19-000136.hdr.sgml : 20190820 20190820175841 ACCESSION NUMBER: 0001014108-19-000136 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190816 FILED AS OF DATE: 20190820 DATE AS OF CHANGE: 20190820 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sansone Christopher R. CENTRAL INDEX KEY: 0001519525 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 191040710 MAIL ADDRESS: STREET 1: C/O SANSONE ADVISORS, LLC STREET 2: 151 BODMAN PLACE, SUITE 100 CITY: RED BANK STATE: NJ ZIP: 07701 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: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 BUSINESS PHONE: (248) 291-1210 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2019-08-16 0 0001337013 InfuSystem Holdings, Inc INFU 0001519525 Sansone Christopher R. C/O INFUSYSTEM HOLDINGS, INC. 31700 RESEARCH PARK DRIVE MARYLAND HEIGHTS MI 48071 1 0 0 0 Common Stock 0 D Common Stock 2019-08-16 4 P 0 13583 4.9561 A 1429847 I See Common Stock 2019-08-16 4 P 0 2717 4.9561 A 301105 I See The reported securities are directly owned by Sansone Partners, L.P., a Delaware limited partnership. The Reporting Person is the managing member of (i) the general partner of this limited partnership and (ii) the investment manager of this limited partnership and, as such, may be deemed to indirectly beneficially own the shares held by this limited partnership. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. The reported securities are directly owned by Sansone Partners (QP), L.P., a Delaware limited partnership. The Reporting Person is the managing member of (i) the general partner of this limited partnership and (ii) the investment manager of this limited partnership and, as such, may be deemed to indirectly beneficially own the shares held by this limited partnership. The Reporting Person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/Jeanie Latz, Attorney-in-Fact for Christopher R. Sansone 2019-08-20