FORM 4
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).         
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
                                                                                  
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
                      

1. Name and Address of Reporting Person *

Dilorio Richard
2. Issuer Name and Ticker or Trading Symbol

InfuSystem Holdings, Inc [ INFU ]
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)

__ X __ Director                      _____ 10% Owner
__ X __ Officer (give title below)      _____ Other (specify below)
Chief Executive Officer
(Last)          (First)          (Middle)

C/O INFUSYSTEM HOLDINGS, INC., 31700 RESEARCH PARK DRIVE
3. Date of Earliest Transaction (MM/DD/YYYY)

11/15/2017
(Street)

MADISON HEIGHTS, MI 48071
(City)        (State)        (Zip)
4. If Amendment, Date Original Filed (MM/DD/YYYY)

 
6. Individual or Joint/Group Filing (Check Applicable Line)

_ X _ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Trans. Date 2A. Deemed Execution Date, if any 3. Trans. Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock                  59659   D    

Table II - Derivative Securities Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivate Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Trans. Date 3A. Deemed Execution Date, if any 4. Trans. 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 7. Title and Amount of Securities Underlying Derivative Security
(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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (right to buy)   $2.69                      (1) 7/14/2024   Common Stock   50000     50000   D    
Stock Option (right to buy)   $2.6                      (2) 3/11/2025   Common Stock   25000     25000   D    
Stock Option (right to buy)   $2.76                      (3) 8/16/2026   Common Stock   40000     40000   D    
Stock Option (right to buy)   $2.15                      (4) 3/16/2027   Common Stock   25000     25000   D    
Stock Option (right to buy)   $1.98                      (5) 9/7/2022   Common Stock   25000     25000   D    
Stock Appreciation Rights   $2   11/15/2017     A      200000         (6) 3/31/2019   Common Stock   200000   $0   200000   D    
Stock Option (right to buy)   $2   11/15/2017     A      200000         (7) 11/15/2022   Common Stock   200000   $0   200000   D    

Explanation of Responses:
(1)  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.
(2)  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.
(3)  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.
(4)  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.
(5)  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.
(6)  The stock appreciation rights shall vest and become exercisable beginning on December 31, 2018, based on certain company financial criteria.
(7)  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.

Reporting Owners
Reporting Owner Name / Address
Relationships
Director 10% Owner Officer Other
Dilorio Richard
C/O INFUSYSTEM HOLDINGS, INC.
31700 RESEARCH PARK DRIVE
MADISON HEIGHTS, MI 48071
X
Chief Executive Officer

Signatures
/s/Trent N. Smith, Attorney-in-Fact for Richard Dilorio 12/12/2017
** Signature of Reporting Person Date


Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* 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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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.
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