Form 4 for INFU InfuSystem Holdings, Inc
Accepted 2023-05-22 00:00:00 ET · period of report 2023-05-18 · accession 0001628280-23-019359 · SEC index · Original document
Summary rows
Aggregated the way they appear in lists: one row per insider, transaction code and security table.
| X | Filed | Traded | Ticker | Insider | Title | Type | Price | Qty | Owned | ΔOwn | Value |
|---|---|---|---|---|---|---|---|---|---|---|---|
| D | 2023-05-22 | 2023-05-20 | INFU | Chupa Addam | CIO, Executive VP | M - OptEx | $0.00 | +2,500 | 19.5K | +15% | $0 |
| D | 2023-05-22 | 2023-05-20 | INFU | Chupa Addam | CIO, Executive VP | F - Tax | $9.12 | -1,015 | 18.5K | -5% | -$9,257 |
| DM | 2023-05-22 | 2023-05-18 | INFU | Chupa Addam | CIO, Executive VP | A - Grant | $0.00 | +42.1K | 5,447 | New | $0 |
| D | 2023-05-22 | 2023-05-20 | INFU | Chupa Addam | CIO, Executive VP | M - OptEx | $0.00 | -2,500 | 0 | -100% | $0 |
Purchase Sale Sale after option exercise All abbreviations
Every reported transaction
| # | Table | Security | Date | Code | A/D | Shares | Price | Owned after | Own | Exercise / expiry | Underlying | Footnotes |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | Common | Common Stock | 2023-05-20 | M | A | 2,500 | $0.00 | 19,481 | D | — | — | |
| 2 | Common | Common Stock | 2023-05-20 | F | D | 1,015 | $9.12 | 18,466 | D | — | — | |
| 3 | Derivative | Stock Options (right to buy) | 2023-05-18 | A | A | 36,636 | $0.00 | 36,636 | D | $9.18 · — to 2033-05-18 | 36,636 Common Stock | (F3) The option, representing the right to purchase a total of 36,636 shares of InfuSystem Holdings, Inc. common stock, vests in three equal annual installments beginning May 18, 2024. |
| 4 | Derivative | Restricted Stock Units | 2023-05-20 | M | D | 2,500 | $0.00 | 0 | D | — · — to — | 2,500 Common Stock | (F4) Restricted stock units convert into common stock on a one-for-one basis. (F6) These restricted stock units fully vested on May 20, 2023. |
| 5 | Derivative | Restricted Stock Units | 2023-05-18 | A | A | 5,447 | $0.00 | 5,447 | D | — · — to 2026-05-18 | 5,447 Common Stock | (F4) Restricted stock units convert into common stock on a one-for-one basis. (F5) These restricted stock units will fully vest on May 18, 2026. |