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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KLEINHEINZ CAPITAL PARTNERS, INC. 301 COMMERCE STREET SUITE 1900 FORT WORTH, TX 76102 |
X | |||
Kleinheinz Capital Partners LDC C/O WALKERS SPV LIMITED WALKER HOUSE, 87 MARY STREET GEORGE TOWN, GRAND CAYMAN, E9 KYI-9002 |
X | |||
KLEINHEINZ JOHN B 301 COMMERCE STREET SUITE 1900 FORT WORTH, TX 76102 |
X |
/s/ John Kleinheinz, Director of Kleinheinz Capital Partners, Inc. | 03/01/2010 | |
**Signature of Reporting Person | Date | |
/s/ John Kleinheinz, Managing Director of Kleinheinz Capital Partners, LDC | 03/01/2010 | |
**Signature of Reporting Person | Date | |
/s/ John Kleinheinz | 03/01/2010 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The filing of this Form 4 shall not be construed as an admission that Kleinheinz Capital Partners, Inc., Kleinheinz Capital Partners LDC or John Kleinheinz is or was for the purpose of Section 16(a) of the Securties Exchange Act of 1934, as amended, or otherwise a beneficial owner of any of the shares of common stock, par value $0.0001 per share ("Common Stock") of Infusystem Holdings, Inc. held and owned by Global Undervalued Securities Master Fund, LP. (and by Global Undervalued Securities Fund, LP, Global Undervalued Securities Fund (QP), LP, and Global Undervalued Securities Fund, Ltd., each of which serves as a general partner to, and a feeder fund of, Global Undervalued Securities Master Fund, LP). Pursuant to Rule 16a-1, each of Kleinheinz Capital Partners, Inc., Kleinheinz Capital Partners LDC and John Kleinheinz disclaims such beneficial ownership. |
(2) | Kleinheinz Capital Partners LDC holds indirectly shares of Common Stock on behalf of Global Undervalued Securities Fund, LP, and Global Undervalued Securities Fund (QP), LP for which Kleinheinz Capital Partners LDC serves as general partner. Kleinheinz Capital Partners, Inc. holds indirectly shares of Common Stock on behalf of Global Undervalued Securities Fund, LP, Global Undervalued Securities Fund (QP), LP, Global Undervalued Securitites Fund, Ltd. and Global Undervalued Securities Master Fund, LP, for which Kleinheinz Capital Partners, Inc. serves as investment manager. John Kleinheinz report the shares of Common Stock held indirectly by Kleinheinz Capital Partners LDC and Kleinheinz Capital Partners, Inc. because, as managing director and director, respectively, at the time of purchase, he controlled the voting and disposition of the securitites. |