0001628280-22-031481.txt : 20221206 0001628280-22-031481.hdr.sgml : 20221206 20221206195548 ACCESSION NUMBER: 0001628280-22-031481 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221202 FILED AS OF DATE: 20221206 DATE AS OF CHANGE: 20221206 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: 221448915 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_167037452904433.xml FORM 4 X0306 4 2022-12-02 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 2022-12-02 4 M 0 25000 4.70 A 25346 D Common Stock 2022-12-02 4 S 0 25000 8.7432 D 346 D Stock Option (right to buy) 4.7 2022-12-02 4 M 0 25000 0 D 2024-05-15 Common Stock 25000.0 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 25,000 shares of InfuSystem Holdings, Inc. common stock, vests in twelve equal monthly installments beginning on June 15, 2019. /s/ Kevin Whitman, Attorney-in-Fact for Gregg O. Lehman 2022-12-06