0001104659-14-077196.txt : 20141105 0001104659-14-077196.hdr.sgml : 20141105 20141105192935 ACCESSION NUMBER: 0001104659-14-077196 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130923 FILED AS OF DATE: 20141105 DATE AS OF CHANGE: 20141105 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: 7651 ANAGRAM DRIVE CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 BUSINESS PHONE: 952-345-4200 MAIL ADDRESS: STREET 1: 7651 ANAGRAM DRIVE CITY: EDEN PRAIRIE STATE: MN ZIP: 55344 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CM Capital Venture 4A A/C CENTRAL INDEX KEY: 0001542841 STATE OF INCORPORATION: C3 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 141198392 BUSINESS ADDRESS: STREET 1: LEVEL 9 STREET 2: 545 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 BUSINESS PHONE: 61738382800 MAIL ADDRESS: STREET 1: LEVEL 9 STREET 2: 545 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CM Capital Venture 4B A/C CENTRAL INDEX KEY: 0001542842 STATE OF INCORPORATION: C3 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 141198393 BUSINESS ADDRESS: STREET 1: LEVEL 9 STREET 2: 545 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 BUSINESS PHONE: 61738382800 MAIL ADDRESS: STREET 1: LEVEL 9 STREET 2: 545 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Talu Ventures Pty Ltd CENTRAL INDEX KEY: 0001619365 STATE OF INCORPORATION: C3 FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35312 FILM NUMBER: 141198394 BUSINESS ADDRESS: STREET 1: LEVEL 8 STREET 2: 379 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 BUSINESS PHONE: 61 7 3838 2888 MAIL ADDRESS: STREET 1: LEVEL 8 STREET 2: 379 QUEEN STREET CITY: BRISBANE STATE: C3 ZIP: QLD 4000 4 1 a4.xml 4 X0306 4 2013-09-23 0 0001506492 Sunshine Heart, Inc. SSH 0001619365 Talu Ventures Pty Ltd LEVEL 8, 379 QUEEN STREET BRISBANE C3 QLD 4000 AUSTRALIA 0 0 1 0 0001542842 CM Capital Venture 4B A/C LEVEL 8, 379 QUEEN STREET BRISBANE C3 QLD 4000 AUSTRALIA 0 0 1 0 0001542841 CM Capital Venture 4A A/C LEVEL 8, 379 QUEEN STREET BRISBANE C3 QLD 4000 AUSTRALIA 0 0 1 0 Common Stock 2013-09-23 4 P 0 62500 10.50 A 812856 I By: CM Capital Venture Trust 4A Common Stock 2013-09-23 4 P 0 62500 10.50 A 812856 I By: CM Capital Venture Trust 4B Common Stock Warrant (right to buy) Common Stock 188393 I By: CM Capital Venture Trust 4A Common Stock Warrant (right to buy) Common Stock 188393 I By: CM Capital Venture Trust 4B Represents securities held by CM Capital Venture Trust 4A. Beginning January 1, 2013, Talu Ventures Pty Ltd. became the investment manager of CM Capital Venture Trust 4A and has voting and investment power over the securities held by CM Capital Venture Trust 4A, but disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. Voting and investment decisions are made by an investment committee of five individuals, each of whom disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. Represents securities held by CM Capital Venture Trust 4B. Beginning January 1, 2013, Talu Ventures Pty Ltd. became the investment manager of CM Capital Venture Trust 4B and has voting and investment power over the securities held by CM Capital Venture Trust 4B, but disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. Voting and investment decisions are made by an investment committee of five individuals, each of whom disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. /s/ Jonathan Whitehouse CM CAPITAL VENTURE TRUST 4A 2014-11-03 /s/ Jonathan Whitehouse CM CAPITAL VENTURE TRUST 4B 2014-11-03 /s/ Jonathan Whitehouse TALU VENTURES PTY LTD 2014-11-03