0001628280-19-007595.txt : 20190605
0001628280-19-007595.hdr.sgml : 20190605
20190605164056
ACCESSION NUMBER: 0001628280-19-007595
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: Gersh Lisa
CENTRAL INDEX KEY: 0001329958
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38593
FILM NUMBER: 19880207
MAIL ADDRESS:
STREET 1: C/O HASBRO, INC.
STREET 2: 1011 NEWPORT AVENUE
CITY: PAWTUCKET
STATE: RI
ZIP: 02861
FORMER NAME:
FORMER CONFORMED NAME: Hall Lisa Gersh
DATE OF NAME CHANGE: 20050613
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_155976724160617.xml
FORM 4
X0306
4
2019-06-03
0
0001688757
ESTABLISHMENT LABS HOLDINGS INC.
ESTA
0001329958
Gersh Lisa
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
12000
0
A
2029-06-03
Common Shares
12000.0
12000
D
One-third of the shares subject to the option vest on June 3, 2020 and each one-year anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.
/s/ Renee M. Gaeta, by power of attorney
2019-06-05