SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
GBS Venture Partners Pty, Ltd

(Last) (First) (Middle)
LEVEL 5
71 COLLINS ST.

(Street)
MELBOURNE C3 VIC 3000

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
02/14/2012
3. Issuer Name and Ticker or Trading Symbol
Sunshine Heart, Inc. [ SSH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 379,596 I By GBS Bioventures II A/C (1)
Common Stock 815,165 I By GBS Bioventures III A/C (2)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Warrant (right to buy) (3) 12/08/2014 Common Stock 79,083 6.5114 I By GBS Bioventures II A/C (1)
Common Stock Warrant (right to buy) (3) 12/08/2014 Common Stock 169,826 6.5114 I By GBS Bioventures III A/C (2)
1. Name and Address of Reporting Person*
GBS Venture Partners Pty, Ltd

(Last) (First) (Middle)
LEVEL 5
71 COLLINS ST.

(Street)
MELBOURNE C3 VIC 3000

(City) (State) (Zip)
1. Name and Address of Reporting Person*
GBS Bioventures II A/C

(Last) (First) (Middle)
LEVEL 5
71 COLLINS ST

(Street)
MELBOURNE C3 VIC 3000

(City) (State) (Zip)
1. Name and Address of Reporting Person*
GBS Bioventures III A/C

(Last) (First) (Middle)
LEVEL 5
71 COLLINS ST

(Street)
MELBOURNE C3 VIC 3000

(City) (State) (Zip)
Explanation of Responses:
1. Represents securities held directly by GBS Bioventures II A/C. Dr. Geoffrey Brooke is a managing director of GBS Venture Partners Pty, Ltd. which manages GBS Bioventures II A/C. Dr. Brooke, a director of the Issuer, shares voting and investment power with another partner and may be deemed to be an indirect beneficial owner of the reported securities. Dr. Brooke disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest. This report shall not be deemed an admission that Dr. Brooke is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
2. Represents securities held directly by GBS Bioventures III A/C. Dr. Geoffrey Brooke is a managing director of GBS Venture Partners Pty, Ltd. which manages GBS Bioventures III A/C. Dr. Brooke, a director of the Issuer, shares voting and investment power with another partner and may be deemed to be an indirect beneficial owner of the reported securities. Dr. Brooke disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest. This report shall not be deemed an admission that Dr. Brooke is the beneficial owner of such securities for purposes of Section 16 or for any other purpose.
3. Immediately exercisable.
/s/ Kassendra D. Galindo, attorney-in-fact 02/28/2012
/s/ Kassendra D. Galindo, attorney-in-fact 02/28/2012
/s/ Kassendra D. Galindo, attorney-in-fact 02/28/2012
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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