0001014108-21-000204.txt : 20211129 0001014108-21-000204.hdr.sgml : 20211129 20211129184849 ACCESSION NUMBER: 0001014108-21-000204 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211124 FILED AS OF DATE: 20211129 DATE AS OF CHANGE: 20211129 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Sheehan Jeannine CENTRAL INDEX KEY: 0001775188 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 211457881 MAIL ADDRESS: STREET 1: 31700 RESEARCH PARK DRIVE CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 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 primary_doc.xml PRIMARY DOCUMENT X0306 4 2021-11-24 0 0001337013 InfuSystem Holdings, Inc INFU 0001775188 Sheehan Jeannine 3851 WEST HAMLIN ROAD ROCHESTER HILL MI 48309 0 1 0 0 Chief Administrative Officer Common Stock 2021-11-24 4 M 0 7461 4.48 A 17607 D Common Stock 2021-11-24 4 S 0 7461 18.01 D 10146 D Common Stock 345 I By children This total includes 982 shares acquired recently through the Company's Employee Stock Purchase Plan. The price reported in Column 4 is a weighted average price. The shares reported herein were sold in multiple transactions. The reporting person undertakes to provide to the Issuer, and security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. /s/ Kevin Whitman, Attorney-in-Fact for Jeannine Sheehan 2021-11-29