0001596771-17-000033.txt : 20170420 0001596771-17-000033.hdr.sgml : 20170420 20170420162400 ACCESSION NUMBER: 0001596771-17-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170419 FILED AS OF DATE: 20170420 DATE AS OF CHANGE: 20170420 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Sunshine Heart, Inc. CENTRAL INDEX KEY: 0001506492 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 680533453 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 952-345-4200 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ERB JOHN L CENTRAL INDEX KEY: 0001213867 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 17773268 MAIL ADDRESS: STREET 1: C/O VASCULAR SOLUTIONS, INC. STREET 2: 6464 SYCAMORE COURT N. CITY: MINNEAPOLIS, STATE: MN ZIP: 55369 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-04-19 0 0001506492 Sunshine Heart, Inc. SSH 0001213867 ERB JOHN L 12988 VALLEY VIEW ROAD EDEN PRAIRIE MN 55344 1 1 0 0 CEO and President Common Stock 2017-04-19 4 P 0 100000 A 115468 D Warrant to Purchase Common Stock (right to buy) 1.1 2017-04-19 4 P 0 100000 A 2017-04-24 2022-04-24 Common Stock 100000 100000 D The reporting person purchased Class A Units ("Units") consisting of one share of common stock and one warrant to purchase one share of common stock for $1.00 per Unit in an underwritten public offering by the issuer. The shares of common stock and warrants comprising the Units were issued separately. The offering is expected to close on April 24, 2017. On January 12, 2017, the issuer effected a 1-for-30 reverse stock split of the issued and outstanding shares of its common stock. Upon effectiveness of the reverse stock split, every 30 shares of common stock was automatically converted into one share of common stock, resulting in a decrease of the insider's common stock holdings of 448,660 shares. Gayle C. Aiken, by Power of Attorney 2017-04-20