0001628280-21-011127.txt : 20210526
0001628280-21-011127.hdr.sgml : 20210526
20210526163821
ACCESSION NUMBER: 0001628280-21-011127
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210525
FILED AS OF DATE: 20210526
DATE AS OF CHANGE: 20210526
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: 21966879
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_162206148133767.xml
FORM 4
X0306
4
2021-05-25
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)
78.11
2021-05-25
4
A
0
10000
0
A
2031-05-25
Common Shares
10000.0
10000
D
The shares subject to the option vest in full on the earlier of May 25, 2022 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
2021-05-26