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InfuSystem Holdings, Inc — Director's Dealing 2017
Dec 12, 2017
33639_dirs_2017-12-12_6c194b19-1a2f-42b0-bfd0-8b56b2865dd2.zip
Director's Dealing
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SEC Form 4 — Statement of Changes in Beneficial Ownership
Issuer: InfuSystem Holdings, Inc (INFU)
CIK: 0001337013
Period of Report: 2017-11-15
Reporting Person: Dilorio Richard (Director, Chief Executive Officer)
Derivative Transactions
| Date | Security | Exercise Price | Code | Shares | A/D | Expiration | Underlying | Ownership |
|---|---|---|---|---|---|---|---|---|
| 2017-11-15 | Stock Appreciation Rights | $2 | A | 200000 | Acquired | 2019-03-31 | Common Stock (200000) | Direct |
| 2017-11-15 | Stock Option (right to buy) | $2 | A | 200000 | Acquired | 2022-11-15 | Common Stock (200000) | Direct |
Holdings (Non-Derivative)
| Security | Shares | Ownership |
|---|---|---|
| Common Stock | 59659 | Direct |
Holdings (Derivative)
| Security | Exercise Price | Expiration | Underlying | Shares | Ownership |
|---|---|---|---|---|---|
| Stock Option (right to buy) | $2.69 | 2024-07-14 | Common Stock (50000) | 50000 | Direct |
| Stock Option (right to buy) | $2.6 | 2025-03-11 | Common Stock (25000) | 25000 | Direct |
| Stock Option (right to buy) | $2.76 | 2026-08-16 | Common Stock (40000) | 40000 | Direct |
| Stock Option (right to buy) | $2.15 | 2027-03-16 | Common Stock (25000) | 25000 | Direct |
| Stock Option (right to buy) | $1.98 | 2022-09-07 | Common Stock (25000) | 25000 | Direct |
Footnotes
F1: The option, representing the right to purchase a total of 50,000 shares of InfuSystem Holdings, Inc. common stock, vests in thirty-six monthly installments beginning August 14, 2014.
F2: The option, representing the right to purchase a total of 25,000 shares of InfuSystem Holdings, Inc. common stock, vests in forty-eight monthly installments beginning April 11, 2015.
F3: The option, representing the right to purchase a total of 40,000 shares of InfuSystem Holdings, Inc. common stock, vests in thirty-six monthly installments beginning September 16, 2016.
F4: The option, representing the right to purchase a total of 25,000 shares of InfuSystems Holdings, Inc. common stock, vests in thirty-six monthly installments beginning April 16, 2017.
F5: The option, representing the right to purchase a total of 25,000 shares of InfuSystem Holdings, Inc. common stock, vests annually over three years beginning September 7, 2018.
F6: The stock appreciation rights shall vest and become exercisable beginning on December 31, 2018, based on certain company financial criteria.
F7: The option, representing the right to purchase a total of 200,000 shares of InfuSystem Holdings, Inc. common stock, vests over four-year period on a monthly basis beginning December 15, 2017.