SEC Form 4 · accession 0001014108-16-000490
InfuSystem Holdings, Inc · INFU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Eric K Steen
Officer — President and CEO · Director
Period of report
Aug 18, 2016
Accepted (ET)
Aug 18, 2016 · 4:15 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001337013
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy)F1 | $2.77 | Aug 18, 2016 | A | 75,000 | A | — | Aug 18, 2026 | Common Stock | 75,000 | 75,000 | D |
Explanation of responses
- F1The option, representing the right to purchase a total of 75,000 shares of InfuSystem Holdings, Inc. common stock, vests in thirty-six monthly installments beginning September 18, 2016.