InfuSystem Holdings, Inc — Director's Dealing 2012

Jan 27, 2012

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: InfuSystem Holdings, Inc (INFU)
CIK: 0001337013
Period of Report: 2009-02-03

Reporting Person: McDevitt Sean (Director, Chief Executive Officer)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2009-02-03	Common Stock, par value $0.0001 per share	A	1234044	—	Acquired	1234044	Indirect

Footnotes

F1: On July 26, 2006, InfuSystem Holdings, Inc. (the "Issuer") granted (the "Grant") the reporting person the right to receive shares of common stock, par value $0.0001 per share ("Common Stock") following the completion of an acquisition meeting certain criteria. On October 25, 2007, such an acquisition was completed (the "Acquisition"). On February 3, 2009, the Issuer issued 1,234,044 shares of Common Stock pursuant to such Grant to a limited liability company of which the reporting person is the sole member.

F2: Although the reporting person inadvertently failed to disclose this transaction when it occurred, the 1,234,044 shares of Common Stock received in this transaction have been included in the total number of shares beneficially owned by the reporting person in his subsequent Form 4 filings and the Issuer's periodic reports filed with the Securities and Exchange Commission.