SEC Form 4 · accession 0001014108-18-000195
InfuSystem Holdings, Inc · INFU
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard Dilorio
Officer — Chief Executive Officer · Director
Period of report
Aug 23, 2018
Accepted (ET)
Aug 27, 2018 · 5:37 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF1,F2 | — | Aug 23, 2018 | A | 125,000 | A | — | Aug 23, 2021 | Common Stock | 125,000 | 125,000 | D |
| Stock Option (right to buy)F3 | $3.18 | Aug 23, 2018 | A | 200,000 | A | — | Aug 23, 2023 | Common Stock | 200,000 | 200,000 | D |
Explanation of responses
- F1Restricted stock units convert into common stock on a one-for-one basis.
- F2These restricted stock units are eligible for vesting over a three-year period beginning August 23, 2018. The first 25,000 will vest if the company's closing stock price is above $4.00 for ten consecutive trading days prior to the one year anniversary of the grant. An additional 50,000 will vest if the company's closing stock price is above $5.00 for ten consecutive trading days prior to the two year anniversary of the grant. An additional 50,000 will vest if the company's closing stock price is above $6.00 for ten consecutive trading days prior to the three year anniversary of the grant.
- F3The option, representing the right to purchase a total of 200,000 shares of InfuSystem Holdings, Inc. common stock, vests in three annual installments beginning on August 23, 2019.