|4May 20, 6:54 PM ET

Chupa Addam 4

4 · InfuSystem Holdings, Inc · Filed May 20, 2025

Insider Transaction Report

Form 4
Period: 2025-05-16
Chupa Addam
Executive VP and CIO
Transactions
  • Award

    Restricted Stock Units

    2025-05-16+13,12513,125 total
    Exp: 2028-05-16Common Stock (13,125 underlying)
  • Award

    Stock Option (right to buy)

    2025-05-16+31,17631,176 total
    Exercise: $6.00Exp: 2035-05-16Common Stock (31,176 underlying)
  • Tax Payment

    Common Stock

    2025-05-17$6.15/sh3,660$22,50944,956 total
  • Exercise/Conversion

    Restricted Stock Units

    2025-05-1710,0000 total
    From: 2025-05-17Exp: 2025-05-17Common Stock (10,000 underlying)
  • Exercise/Conversion

    Common Stock

    2025-05-17+10,00048,616 total
Holdings
  • Common Stock

    38,616
Footnotes (5)
  • [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.

Documents

1 file
  • 4
    wk-form4_1747781667.xmlPrimary

    FORM 4