SEC Form 4 · accession 0001014108-17-000096
InfuSystem Holdings, Inc · INFU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Trent N. Smith
Officer — Exec VP,CAO & Corp Controller
Period of report
Mar 16, 2017
Accepted (ET)
May 4, 2017 · 7:23 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 | $2.15 | Mar 16, 2017 | A | 20,000 | A | — | Mar 16, 2027 | Common Stock | 20,000 | 20,000 | D |
Explanation of responses
- F1The option, representing the right to purchase a total of 20,000 shares of InfuSystem Holdings, Inc. common stock, vests in 36-monthly installments beginning on April 16, 2017.