Form D Raw Data - Electronic Filing Depository

EFDID: 62168EFD: Raw Data

Issuer: Sunshine Heart, Inc. (0001506492) - D

Accession: 0001506492-12-000002 () (EDGAR Files) (Form D)

Edgar Posted: Sep. 19, 2012
EFD Posted: Aug. 7, 2014

- < edgarSubmission >

< schemaVersion > X0706 </ schemaVersion >

< submissionType > D </ submissionType >

< testOrLive > LIVE </ testOrLive >

- < primaryIssuer >

< cik > 0001506492 </ cik >

< entityName > Sunshine Heart, Inc. </ entityName >

- < issuerAddress >

< street1 > 12988 Valley View Road </ street1 >

< city > EDEN PRAIRIE </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ issuerAddress >

< issuerPhoneNumber > 952-345-4200 </ issuerPhoneNumber >

< jurisdictionOfInc > DELAWARE </ jurisdictionOfInc >

- < issuerPreviousNameList >

< value > None </ value >

</ issuerPreviousNameList >

- < edgarPreviousNameList >

< value > None </ value >

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< entityType > Corporation </ entityType >

- < yearOfInc >

< overFiveYears > true </ overFiveYears >

</ yearOfInc >

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< firstName > David </ firstName >

< lastName > Rosa </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

< relationship > Director </ relationship >

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< relationshipClarification />

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- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Kevin </ firstName >

< lastName > Bassett </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

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- < relatedPersonName >

< firstName > Jim </ firstName >

< lastName > Yearick </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Executive Officer </ relationship >

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< relationshipClarification />

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- < relatedPersonInfo >

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< firstName > Jeffrey </ firstName >

< lastName > Mathiesen </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< relationship > Executive Officer </ relationship >

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< firstName > William </ firstName >

< lastName > Peters </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

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< relationship > Director </ relationship >

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< firstName > Nicholas </ firstName >

< lastName > Callinan </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< relationship > Director </ relationship >

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< firstName > Geoffrey </ firstName >

< lastName > Brooke </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< relationship > Director </ relationship >

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< firstName > Mark </ firstName >

< lastName > Harvey </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< relationship > Director </ relationship >

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< firstName > Paul </ firstName >

< lastName > Buckman </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< relationship > Director </ relationship >

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< firstName > Gregory </ firstName >

< lastName > Waller </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

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< firstName > John </ firstName >

< lastName > Erb </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

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< firstName > Donal </ firstName >

< lastName > O'Dwyer </ lastName >

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< street1 > 12988 Valley View Road </ street1 >

< city > Eden Prairie </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55344 </ zipCode >

</ relatedPersonAddress >

- < relatedPersonRelationshipList >

< relationship > Director </ relationship >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

</ relatedPersonsList >

- < offeringData >

- < industryGroup >

< industryGroupType > Biotechnology </ industryGroupType >

</ industryGroup >

- < issuerSize >

< revenueRange > $1 - $1,000,000 </ revenueRange >

</ issuerSize >

- < federalExemptionsExclusions >

< item > 06 </ item >

</ federalExemptionsExclusions >

- < typeOfFiling >

- < newOrAmendment >

< isAmendment > false </ isAmendment >

</ newOrAmendment >

- < dateOfFirstSale >

< value > 2012-09-07 </ value >

</ dateOfFirstSale >

</ typeOfFiling >

- < durationOfOffering >

< moreThanOneYear > false </ moreThanOneYear >

</ durationOfOffering >

- < typesOfSecuritiesOffered >

< isOptionToAcquireType > true </ isOptionToAcquireType >

</ typesOfSecuritiesOffered >

- < businessCombinationTransaction >

< isBusinessCombinationTransaction > false </ isBusinessCombinationTransaction >

< clarificationOfResponse />

</ businessCombinationTransaction >

< minimumInvestmentAccepted > 0 </ minimumInvestmentAccepted >

< salesCompensationList />

- < offeringSalesAmounts >

< totalOfferingAmount > 700000 </ totalOfferingAmount >

< totalAmountSold > 700000 </ totalAmountSold >

< totalRemaining > 0 </ totalRemaining >

< clarificationOfResponse />

</ offeringSalesAmounts >

- < investors >

< hasNonAccreditedInvestors > false </ hasNonAccreditedInvestors >

< totalNumberAlreadyInvested > 2 </ totalNumberAlreadyInvested >

</ investors >

- < salesCommissionsFindersFees >

- < salesCommissions >

< dollarAmount > 0 </ dollarAmount >

</ salesCommissions >

- < findersFees >

< dollarAmount > 0 </ dollarAmount >

</ findersFees >

< clarificationOfResponse />

</ salesCommissionsFindersFees >

- < useOfProceeds >

- < grossProceedsUsed >

< dollarAmount > 0 </ dollarAmount >

</ grossProceedsUsed >

< clarificationOfResponse />

</ useOfProceeds >

- < signatureBlock >

< authorizedRepresentative > false </ authorizedRepresentative >

- < signature >

< issuerName > Sunshine Heart, Inc. </ issuerName >

< signatureName > /s/ Jeffrey Mathiesen </ signatureName >

< nameOfSigner > Jeffery Mathiesen </ nameOfSigner >

< signatureTitle > Secretary </ signatureTitle >

< signatureDate > 2012-09-18 </ signatureDate >

</ signature >

</ signatureBlock >

</ offeringData >

</ edgarSubmission >