Chupa Addam 4

4 · InfuSystem Holdings, Inc · Filed May 22, 2023

Form 4

Period: 2023-05-18

Executive VP and CIO

Transactions

Exercise/Conversion
Common Stock
2023-05-20+2,500→ 19,481 total
Tax Payment
Common Stock
2023-05-20$9.12/sh−1,015$9,257→ 18,466 total
Award
Stock Options (right to buy)
2023-05-18+36,636→ 36,636 total
Exercise: $9.18Exp: 2033-05-18→ Common Stock (36,636 underlying)
Exercise/Conversion
Restricted Stock Units
2023-05-20−2,500→ 0 total
→ Common Stock (2,500 underlying)
Award
Restricted Stock Units
2023-05-18+5,447→ 5,447 total
Exp: 2026-05-18→ Common Stock (5,447 underlying)

Footnotes (6)

[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.

Documents

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