Lachance Carrie 4

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

Form 4

Period: 2025-05-16

DirectorPresident and COO

Transactions

Tax Payment
Common Stock
2025-05-17$6.15/sh−6,090$37,454→ 201,849 total
Award
Stock Options (right to buy)
2025-05-16+74,228→ 74,228 total
Exercise: $6.00From: 2026-05-16Exp: 2035-05-16→ Common Stock (74,228 underlying)
Award
Stock Option (right to buy)
2025-05-16+128,000→ 128,000 total
Exercise: $6.00From: 2026-05-16Exp: 2035-05-16→ Common Stock (128,000 underlying)
Exercise/Conversion
Restricted Stock Units
2025-05-17−17,727→ 0 total
→ Common Stock (17,727 underlying)
Exercise/Conversion
Common Stock
2025-05-17+17,727→ 207,939 total
Award
Restricted Stock Units
2025-05-16+31,250→ 31,250 total
From: 2026-05-16Exp: 2028-05-16→ Common Stock (31,250 underlying)

Holdings

Footnotes (5)

[F1]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
[F2]The option, representing the right to purchase a total of 74,228 shares of InfuSystem Holdings, Inc. common stock, vests in four equal annual installments beginning May 16, 2026.
[F3]Restricted stock units convert into common stock on a one-for-one basis.
[F4]These restricted stock units vest in three equal annual installments beginning on May 16, 2026.
[F5]These restricted stock units cliff vested on May 17, 2025.

Documents

1 file