Form D Raw Data - Electronic Filing Depository

EFDID: 205845EFD: Raw Data

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

Accession: 0001506492-16-000002 () (EDGAR Files) (Form D)

Edgar Posted: Nov. 9, 2016
EFD Posted: Nov. 9, 2016

- < edgarSubmission >

< schemaVersion > X0707 </ 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 >

</ edgarPreviousNameList >

< entityType > Corporation </ entityType >

- < yearOfInc >

< overFiveYears > true </ overFiveYears >

</ yearOfInc >

</ primaryIssuer >

- < relatedPersonsList >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > John </ firstName >

< middleName > L. </ middleName >

< lastName > Erb </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Claudia </ firstName >

< lastName > Drayton </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Eric </ firstName >

< lastName > Lovett </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Jon </ firstName >

< lastName > Salveson </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Molly </ firstName >

< lastName > Wade </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

</ relatedPersonRelationshipList >

< relationshipClarification />

</ relatedPersonInfo >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Gregory </ firstName >

< lastName > Waller </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 >

- < relatedPersonInfo >

- < relatedPersonName >

< firstName > Warren </ firstName >

< middleName > S. </ middleName >

< lastName > Watson </ lastName >

</ relatedPersonName >

- < relatedPersonAddress >

< 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 > Decline to Disclose </ revenueRange >

</ issuerSize >

- < federalExemptionsExclusions >

< item > 06b </ item >

</ federalExemptionsExclusions >

- < typeOfFiling >

- < newOrAmendment >

< isAmendment > false </ isAmendment >

</ newOrAmendment >

- < dateOfFirstSale >

< value > 2016-10-30 </ value >

</ dateOfFirstSale >

</ typeOfFiling >

- < durationOfOffering >

< moreThanOneYear > false </ moreThanOneYear >

</ durationOfOffering >

- < typesOfSecuritiesOffered >

< isEquityType > true </ isEquityType >

< isOptionToAcquireType > true </ isOptionToAcquireType >

< isSecurityToBeAcquiredType > true </ isSecurityToBeAcquiredType >

</ typesOfSecuritiesOffered >

- < businessCombinationTransaction >

< isBusinessCombinationTransaction > false </ isBusinessCombinationTransaction >

< clarificationOfResponse />

</ businessCombinationTransaction >

< minimumInvestmentAccepted > 0 </ minimumInvestmentAccepted >

- < salesCompensationList >

- < recipient >

< recipientName > Northland Securities, Inc. </ recipientName >

< recipientCRDNumber > 40258 </ recipientCRDNumber >

< associatedBDName > None </ associatedBDName >

< associatedBDCRDNumber > None </ associatedBDCRDNumber >

- < recipientAddress >

< street1 > 45 South 7th Street </ street1 >

< street2 > Suite 2000 </ street2 >

< city > Minneapolis </ city >

< stateOrCountry > MN </ stateOrCountry >

< stateOrCountryDescription > MINNESOTA </ stateOrCountryDescription >

< zipCode > 55402 </ zipCode >

</ recipientAddress >

- < statesOfSolicitationList >

< state > NJ </ state >

< description > NEW JERSEY </ description >

< state > NY </ state >

< description > NEW YORK </ description >

</ statesOfSolicitationList >

< foreignSolicitation > false </ foreignSolicitation >

</ recipient >

</ salesCompensationList >

- < offeringSalesAmounts >

< totalOfferingAmount > 3600000 </ totalOfferingAmount >

< totalAmountSold > 3600000 </ totalAmountSold >

< totalRemaining > 0 </ totalRemaining >

< clarificationOfResponse > Total offering amount includes the concurrent registered offering of preferred stock and excludes proceeds totaling up to $3,811,765 from the exercise of the warrants. </ clarificationOfResponse >

</ offeringSalesAmounts >

- < investors >

< hasNonAccreditedInvestors > false </ hasNonAccreditedInvestors >

< totalNumberAlreadyInvested > 2 </ totalNumberAlreadyInvested >

</ investors >

- < salesCommissionsFindersFees >

- < salesCommissions >

< dollarAmount > 216000 </ dollarAmount >

</ salesCommissions >

- < findersFees >

< dollarAmount > 0 </ dollarAmount >

</ findersFees >

< clarificationOfResponse > Excludes 1,270,588 warrants to purchase common stock received by placement agent as part of its compensation. </ clarificationOfResponse >

</ salesCommissionsFindersFees >

- < useOfProceeds >

- < grossProceedsUsed >

< dollarAmount > 0 </ dollarAmount >

</ grossProceedsUsed >

< clarificationOfResponse > Proceeds to be used for working capital and general corporate purposes. </ clarificationOfResponse >

</ useOfProceeds >

- < signatureBlock >

< authorizedRepresentative > false </ authorizedRepresentative >

- < signature >

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

< signatureName > /s/ Claudia Drayton </ signatureName >

< nameOfSigner > Claudia Drayton </ nameOfSigner >

< signatureTitle > Chief Financial Officer </ signatureTitle >

< signatureDate > 2016-11-08 </ signatureDate >

</ signature >

</ signatureBlock >

</ offeringData >

</ edgarSubmission >