Form 4 for INFU InfuSystem Holdings, Inc
Accepted 2024-05-21 00:00:00 ET · period of report 2024-05-17 · accession 0001628280-24-024592 · 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 | 2024-05-21 | 2024-05-17 | INFU | Chupa Addam | CIO, Executive VP | A - Grant | $0.00 | +2,850 | 24.8K | +13% | $0 |
| D | 2024-05-21 | 2024-05-21 | INFU | Chupa Addam | CIO, Executive VP | P - Purchase | $6.67 | +1,000 | 24.8K | +4% | +$6,670 |
| D | 2024-05-21 | 2024-05-17 | INFU | Chupa Addam | CIO, Executive VP | F - Tax | $6.44 | -987 | 23.8K | -4% | -$6,356 |
| DM | 2024-05-21 | 2024-05-17 | INFU | Chupa Addam | CIO, Executive VP | A - Grant | $0.00 | +65.4K | 11.8K | New | $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 | 2024-05-17 | A | A | 2,850 | $0.00 | 24,761 | D | — | — | (F2) On May 17, 2024, 2,850 performance-based restricted stock units, granted on May 17, 2022, vested |
| 2 | Common | Common Stock | 2024-05-21 | P | A | 1,000 | $6.67 | 24,774 | D | — | — | (F4) The price reported in Column 4 is a weighted average price. These shares reported herein were purchased 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 purchased at each separate price. |
| 3 | Common | Common Stock | 2024-05-17 | F | D | 987 | $6.44 | 23,774 | D | — | — | |
| 4 | Derivative | Stock Option (right to buy) | 2024-05-17 | A | A | 53,528 | $0.00 | 53,528 | D | $6.34 · — to 2034-05-17 | 53,528 Common Stock | (F6) The option, representing the right to purchase a total of 53,528 shares of InfuSystem Holdings, Inc. common stock, vests in four equal annual installments beginning May 17, 2025. |
| 5 | Derivative | Restricted Stock Units | 2024-05-17 | A | A | 11,830 | $0.00 | 11,830 | D | $0.00 · 2027-05-17 to 2027-05-17 | 11,830 Common Stock | (F5) Restricted stock units convert into common stock on a one-for-one basis. |