|4May 21, 6:14 PM ET

Chupa Addam 4

4 · InfuSystem Holdings, Inc · Filed May 21, 2024

Insider Transaction Report

Form 4
Period: 2024-05-17
Chupa Addam
Executive VP and CIO
Transactions
  • Award

    Restricted Stock Units

    2024-05-17+11,83011,830 total
    Exercise: $0.00From: 2027-05-17Exp: 2027-05-17Common Stock (11,830 underlying)
  • Award

    Common Stock

    2024-05-17+2,85024,761 total
  • Tax Payment

    Common Stock

    2024-05-17$6.44/sh987$6,35623,774 total
  • Award

    Stock Option (right to buy)

    2024-05-17+53,52853,528 total
    Exercise: $6.34Exp: 2034-05-17Common Stock (53,528 underlying)
  • Purchase

    Common Stock

    2024-05-21$6.67/sh+1,000$6,67024,774 total
Holdings
  • Common Stock

    21,911
Footnotes (6)
  • [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.

Documents

1 file
  • 4
    wk-form4_1716329652.xmlPrimary

    FORM 4