Addam Chupa - 16 May 2025 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
16 May 2025
Net transactions value
-$22,509
Form type
4
Filing time
20 May 2025, 18:54:34 UTC
Previous filing
04 Nov 2024
SEC
View on sec.gov

Reporting Owners (1)

Name Relationship Address Signature Signature date CIK
Chupa Addam Executive VP and CIO C/O INFUSYSTEM HOLDINGS, INC., 3851 WEST HAMLIN ROAD, ROCHESTER HILLS /s/ Kevin Whitman, Attorney-in-Fact for Addam Chupa 20 May 2025 0001953233

Transactions Table

Type Sym Class Transaction Value $ Shares Change % * Price $ Shares After Date Ownership Footnotes
transaction INFU Common Stock Options Exercise $0 +10,000 +26% $0.000000 48,616 17 May 2025 Direct
transaction INFU Common Stock Tax liability $22,509 -3,660 -7.5% $6.15 44,956 17 May 2025 Direct F2
holding INFU Common Stock 38,616 16 May 2025 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 Stock Option (right to buy) Award $0 +31,176 $0.000000 31,176 16 May 2025 Common Stock 31,176 $6.00 Direct F3
transaction INFU Restricted Stock Units Award $0 +13,125 $0.000000 13,125 16 May 2025 Common Stock 13,125 Direct F4, F5
transaction INFU Restricted Stock Units Options Exercise $0 -10,000 -100% $0.000000 0 17 May 2025 Common Stock 10,000 Direct F4
* 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 1,421 shares acquired recently through the Company's Employee Stock Purchase Plan
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 17, 2025
F3 The option, representing the right to purchase a total of 31,176 shares of InfuSystem Holdings, Inc. common stock, vests in four equal annual installments beginning May 16, 2026.
F4 Restricted stock units convert into common stock on a one-for-one basis.
F5 These restricted stock units vest in three equal annual installments beginning on May 16, 2026.