Addam Chupa - 17 May 2023 Form 4 Insider Report for InfuSystem Holdings, Inc (INFU)

Role
Executive VP and CIO
Signature
/s/ Kevin Whitman, Attorney-in-Fact for Addam Chupa
Issuer symbol
INFU
Transactions as of
17 May 2023
Net transactions value
-$34,875
Form type
4
Filing time
19 May 2023, 17:01:50 UTC
Previous filing
04 Nov 2022
Next filing
22 May 2023
SEC
View on sec.gov

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction INFU Common Stock Options Exercise $0 +9,744 +88% $0.000000 20,780 17 May 2023 Direct F1, F2
transaction INFU Common Stock Tax liability $34,875 -3,799 -18% $9.18 16,981 17 May 2023 Direct F3

Derivative Securities (e.g., puts, calls, warrants, options, convertible securities)

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Underlying Class Amount Exercise Price Ownership Footnotes
transaction INFU Restricted Stock Units Options Exercise $0 -9,744 -100% $0.000000* 0 17 May 2023 Common Stock 9,744 Direct F4
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 These restricted stock units vested on May 17, 2023.
F2 This total includes an additional 974 shares acquired recently through the Company's Employee Stock Purchase Plan
F3 Represents the withholding of the Issuer's common stock for the tax liability associated with the vesting and settlement of the common stock issued on May 17, 2023
F4 Restricted stock units convert into common stock on a one-for-one basis.