0001140361-15-024336.txt : 20150615 0001140361-15-024336.hdr.sgml : 20150615 20150615180823 ACCESSION NUMBER: 0001140361-15-024336 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150615 FILED AS OF DATE: 20150615 DATE AS OF CHANGE: 20150615 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lehman Gregg Owen CENTRAL INDEX KEY: 0001376620 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35020 FILM NUMBER: 15932641 MAIL ADDRESS: STREET 1: 309 HADDON COURT CITY: FRANKLIN STATE: X1 ZIP: 37067 4 1 doc1.xml FORM 4 X0306 4 2015-06-15 0 0001337013 InfuSystem Holdings, Inc INFU 0001376620 Lehman Gregg Owen C/O INFUSYSTEM HOLDINGS, INC. 31700 RESEARCH PARK DRIVE MADISON HEIGHTS MI 48071 1 0 0 0 Common Stock 2015-06-15 4 P 0 2000 3.23 A 20000 D /s/ Sean Schembri, attorney-in-fact 2015-06-15