Addam Chupa - 18 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
18 May 2023
Net transactions value
-$9,257
Form type
4
Filing time
22 May 2023, 20:26:56 UTC
Previous filing
19 May 2023
Next filing
13 Feb 2024
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 +2,500 +15% $0.000000 19,481 20 May 2023 Direct F1
transaction INFU Common Stock Tax liability $9,257 -1,015 -5.2% $9.12 18,466 20 May 2023 Direct F2

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 Stock Options (right to buy) Award $0 +36,636 $0.000000 36,636 18 May 2023 Common Stock 36,636 $9.18 Direct F3
transaction INFU Restricted Stock Units Award $0 +5,447 $0.000000 5,447 18 May 2023 Common Stock 5,447 Direct F4, F5
transaction INFU Restricted Stock Units Options Exercise $0 -2,500 -100% $0.000000* 0 20 May 2023 Common Stock 2,500 Direct F4, F6
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 Vesting of restricted stock award granted on May 20, 2020
F2 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 20, 2023
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.
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.
F6 These restricted stock units fully vested on May 20, 2023.