Filing Details

Accession Number:
0001181431-10-017980
Form Type:
4
Zero Holdings:
No
Publication Time:
2010-03-24 13:00:00
Reporting Period:
2010-03-22
Filing Date:
2010-03-24
Accepted Time:
2010-03-24 14:13:15
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1337013 Infusystem Holdings Inc INHI.OB Surgical & Medical Instruments & Apparatus (3841) 203341405
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1190016 Pierre Jean Millon C/O Infusystem Holdings, Inc.
31700 Research Park Drive
Madison Heights MI 48071
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Warrants To Purchase Common Shares Disposition 2010-03-22 42,858 $0.00 267,092 No 4 S Direct
Class A Common Stock, Par Value $0.0001 Per Share Acquisiton 2010-03-22 1,714 $0.00 268,806 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 S Direct
No 4 P Direct
Footnotes
  1. Represents Mr. Millon's tender of 42,858 warrants to purchase common stock par value $0.0001 per share ("Common Stock") of InfuSystem Holdings, Inc. (the "Company") exercisable at $5.00 per share (the "Warrants") pursuant an offer by the Company to exchange (the "Exchange Offer") any and all Warrants for shares of the Company's Common Stock, upon the terms and subject to the conditions set forth in the Company's Exchange Offer, dated February 16, 2010.
  2. Represents the 1,714 shares of Common Stock Mr. Millon received in exchange for the 42,858 Warrants tendered at a ratio of 25 to 1 for shares of Common Stock subject to a lock-up as described in the Exchange Offer materials.