Addam Chupa - 17 May 2024 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 2024
Net transactions value
+$314
Form type
4
Filing time
21 May 2024, 18:14:28 UTC
Previous filing
13 Feb 2024
Next filing
04 Nov 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 Award $0 +2,850 +13% $0.000000 24,761 17 May 2024 Direct F2
transaction INFU Common Stock Tax liability $6,356 -987 -4% $6.44 23,774 17 May 2024 Direct F3
transaction INFU Common Stock Purchase $6,670 +1,000 +4.2% $6.67 24,774 21 May 2024 Direct F4
holding INFU Common Stock 21,911 17 May 2024 Direct F1

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 Award $0 +11,830 $0.000000 11,830 17 May 2024 Common Stock 11,830 $0.000000 Direct F5
transaction INFU Stock Option (right to buy) Award $0 +53,528 $0.000000 53,528 17 May 2024 Common Stock 53,528 $6.34 Direct F6
* An asterisk sign (*) next to the price indicates that the price is likely invalid.

Explanation of Responses:

Id Content
F1 This total includes an additional 892 shares acquired recently through the Company's Employee Stock Purchase Plan
F2 On May 17, 2024, 2,850 performance-based restricted stock units, granted on May 17, 2022, vested
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, 2024
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.
F5 Restricted stock units convert into common stock on a one-for-one basis.
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.