0001596771-17-000004.txt : 20170117 0001596771-17-000004.hdr.sgml : 20170117 20170117162344 ACCESSION NUMBER: 0001596771-17-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170115 FILED AS OF DATE: 20170117 DATE AS OF CHANGE: 20170117 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: Wade Molly CENTRAL INDEX KEY: 0001630401 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 17530990 MAIL ADDRESS: STREET 1: 12988 VALLEY VIEW ROAD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-01-15 0 0001506492 Sunshine Heart, Inc. SSH 0001630401 Wade Molly 12988 VALLEY VIEW ROAD EDEN PRAIRIE MN 55344 0 1 0 0 Vice President Common Stock 2017-01-15 4 F 0 41 8.19 D 909 D On January 12, 2017, the Issuer effected a 1-for-30 reverse stock split of the issued and outstanding shares of its common stock. The monthly vesting of restricted stock units (RSUs) was adjusted to reflect the reverse stock split, and as a result, 41 shares were withheld to satisfy the insider's tax withholding obligation related to the vesting of 82 RSUs. 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 27,550 shares. Stephanie Swan, by Power of Attorney 2017-01-17