-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DPbdXuAsaTJG08ibZJD0clpo8Flw2zMnzHlfTGNpwIe63+qyEHvPlQ4Lr1DPFiMu vZyCKjVkNjiJbj8MB6pMIA== 0001181431-08-036973.txt : 20080605 0001181431-08-036973.hdr.sgml : 20080605 20080605113500 ACCESSION NUMBER: 0001181431-08-036973 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080516 FILED AS OF DATE: 20080605 DATE AS OF CHANGE: 20080605 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: 1551 EAST LINCOLN AVENUE, SUITE 200 CITY: MADISON HEIGHTS STATE: MI ZIP: 48071 BUSINESS PHONE: (248) 546-7047 MAIL ADDRESS: STREET 1: 1551 EAST LINCOLN AVENUE, SUITE 200 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: LaVecchia Pat CENTRAL INDEX KEY: 0001359466 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-51902 FILM NUMBER: 08882304 BUSINESS ADDRESS: BUSINESS PHONE: 212-418-5074 MAIL ADDRESS: STREET 1: 350 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10017 4 1 rrd209859.xml FORM 4 X0202 4 2008-05-16 0 0001337013 InfuSystem Holdings, Inc INHI.OB 0001359466 LaVecchia Pat C/O INFUSYSTEM HOLDINGS, INC. 1551 EAST LINCOLN AVENUE, SUITE 200 MADISON HEIGHTS MI 48071 1 0 0 0 Common Stock, par value $0.0001 per share 2008-05-16 4 A 0 257091 0 A 257091 D Common Stock 2008-06-03 4 A 0 20000 0 A 277091 D These shares are subject to forfeiture under certain conditions. /s/ Pat LaVecchia 2008-06-04 -----END PRIVACY-ENHANCED MESSAGE-----