0001628280-22-017734.txt : 20220621
0001628280-22-017734.hdr.sgml : 20220621
20220621202110
ACCESSION NUMBER: 0001628280-22-017734
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220617
FILED AS OF DATE: 20220621
DATE AS OF CHANGE: 20220621
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: 221029719
MAIL ADDRESS:
STREET 1: 309 HADDON COURT
CITY: FRANKLIN
STATE: X1
ZIP: 37067
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_165585725068086.xml
FORM 4
X0306
4
2022-06-17
0
0001337013
InfuSystem Holdings, Inc
INFU
0001376620
Lehman Gregg Owen
C/O INFUSYSTEM HOLDINGS, INC.
3851 WEST HAMLIN ROAD
ROCHESTER HILLS
MI
48309
1
0
0
0
Common Stock
2022-06-17
4
M
0
30000
1.98
A
30346
D
Common Stock
2022-06-17
4
S
0
30000
8.83
D
346
D
Stock Option (right to buy)
1.98
2022-06-17
4
M
0
30000
0
D
2022-09-07
Common Stock
30000.0
0
D
The price reported in Column 4 is a weighted average price. These 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 option, representing the right to purchase a total of 60,000 shares of InfuSystem Holdings, Inc. common stock, vests in twelve monthly installments beginning October 7, 2017.
/s/ Kevin Whitman, Attorney-in-Fact for Gregg O. Lehman
2022-06-21