0001628280-19-007596.txt : 20190605
0001628280-19-007596.hdr.sgml : 20190605
20190605164148
ACCESSION NUMBER: 0001628280-19-007596
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190603
FILED AS OF DATE: 20190605
DATE AS OF CHANGE: 20190605
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CONDON DENNIS E
CENTRAL INDEX KEY: 0001111413
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38593
FILM NUMBER: 19880232
MAIL ADDRESS:
STREET 1: 811 ALSTON RD
CITY: SANTA BARBARA
STATE: CA
ZIP: 93108
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ESTABLISHMENT LABS HOLDINGS INC.
CENTRAL INDEX KEY: 0001688757
STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842]
IRS NUMBER: 981436377
BUSINESS ADDRESS:
STREET 1: PO BOX 3140, COMMERCE HOUSE
STREET 2: WICKHAMS CAY 1, ROAD TOWN
CITY: TORTOLA
STATE: D8
ZIP: VG1110
BUSINESS PHONE: 50624342400
MAIL ADDRESS:
STREET 1: PO BOX 3140, COMMERCE HOUSE
STREET 2: WICKHAMS CAY 1, ROAD TOWN
CITY: TORTOLA
STATE: D8
ZIP: VG1110
4
1
wf-form4_155976729424796.xml
FORM 4
X0306
4
2019-06-03
0
0001688757
ESTABLISHMENT LABS HOLDINGS INC.
ESTA
0001111413
CONDON DENNIS E
C/O MOTIVA USA LLC
16192 COASTAL HIGHWAY
LEWES
DE
19958
1
0
0
0
Stock Option (Right to buy)
23.05
2019-06-03
4
A
0
10000
0
A
2029-06-03
Common Shares
10000.0
10000
D
The shares subject to the option vest in full on the earlier of June 3, 2020 or the day prior to the date of the Issuer's next annual meeting of stockholders, subject to the Reporting Person continuing as a service provider through such date.
/s/ Renee M. Gaeta, by power of attorney
2019-06-05