Form D
View Original Filing
Notice of Exempt Offering of Securities
Item 1. Issuer's Identity
Name of Issuer:
CARDIOVASCULAR SYSTEMS INC
Jurisdiction of Incorporation/Organization
DE
Year of Incorporation/Organization
Over Five Years Ago
Previous Name(s)
- REPLIDYNE, INC.
- REPLIDYNE INC
Item 2 Issuer Principal Place of Business and Contact Information
651 CAMPUS DRIVE
ST. PAUL, MN 55112
Phone Number:
subscription required
Item 3. Related Persons
Name
DAVID L. MARTIN
Address
subscription required
Relationship(s)
- EXECUTIVE OFFICER
- DIRECTOR
Clarification of Response
Item 3. Related Persons
Name
GLEN D. NELSON
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
BRENT G. BLACKEY
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
JOHN H. FRIEDMAN
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
GEOFFREY O. HARTZLER
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
AUGUSTINE LAWLOR
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
EDWARD BROWN
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
LESLIE L. TRIGG
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
JAMES E. FLAHERTY
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
LAURENCE L. BETTERLEY
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
ROBERT J. THATCHER
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
BRIAN DOUGHTY
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
PAUL KOEHN
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
SCOTT KRAUS
Address
subscription required
Relationship(s)
Clarification of Response
Item 3. Related Persons
Name
PAUL TYSKA
Address
subscription required
Relationship(s)
Clarification of Response
Item 4. Industry Group
OTHER HEALTH CARE
Item 5. Issuer Size
Revenue Range (for issuer not specifying "hedge" or "other investment" fund in Item 4 above)
DECLINE TO DISCLOSE
Item 6. Federal Exemptions and Exclusions Claimed
Item 7. Type of Filing
New Notice
Date of First Sale in this Offering:
04/14/2010
Item 8. Duration of Offering
Does the issuer intend this offering to last more than one year?
No
Item 9. Type(s) of Securities Offered
- Debt
- Other: ISSUANCE OF A SENIOR CONVERTIBLE PROMISSORY NOTE, AND THE UNDERLYING SHARES OF COMMON STOCK ISSUABLE UPON CONVERSION THEREOF.
Item 10. Business Combination Transaction
Is this offering being made in connection with a business combination
transaction, such as a merger, acquisition or exchange offer?
No
Clarification of Response
Item 11. Minimum Investment
Minimum Investment accepted from any outside investor
0
Item 13. Offering and Sales Amounts
Total Offering Amount
1500000
Total Amount Sold
1500000
Total Remaining to be Sold
0
Clarification of Response
Item 14. Investors
Securities in the offering have been or may be sold to persons
who do not qualify as accredited investors,
Number of non-accredited investors who already have invested in the offering:
Total number of investors who already have invested in the offering:
1
Item 15. Sales Commissions and Finders' Fees Expenses
Sales Commissions:
0.0
Finders' Fees
0.0
Clarification of Response
Item 16. Use of Proceeds
Provide the amount of the gross proceeds of the offering
that has been or is proposed to be used for payments to any of the persons required
to be named as executive officers,directors or promoters in response to Item 3 above.
0.0
Clarification of Response
Signature and Submission
Issuer Name
CARDIOVASCULAR SYSTEMS INC
Issuer Signature
/S/ LAURENCE L. BETTERLEY
Signer Name
LAURENCE L. BETTERLEY
Signer Title
CHIEF FINANCIAL OFFICER
Signature Date
12/13/2010