0001628280-21-016241.txt : 20210809 0001628280-21-016241.hdr.sgml : 20210809 20210809161338 ACCESSION NUMBER: 0001628280-21-016241 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210805 FILED AS OF DATE: 20210809 DATE AS OF CHANGE: 20210809 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: 211156640 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_162853999727980.xml FORM 4 X0306 4 2021-08-05 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 Common Shares 2021-08-05 4 M 0 10000 18.14 A 10000 D Common Shares 2021-08-05 4 M 0 8000 23.05 A 18000 D Common Shares 2021-08-05 4 S 0 12758 70.2657 D 5242 D Common Shares 2021-08-05 4 S 0 5242 71.2707 D 0 D Stock Option (Right to buy) 18.14 2021-08-05 4 M 0 10000 0 D 2030-05-26 Common Shares 10000.0 22000 D Stock Option (Right to buy) 23.05 2021-08-05 4 M 0 8000 0 D 2029-06-03 Common Shares 8000.0 14000 D This transaction was executed in multiple trades at prices ranging from $70.0101 to $70.9900 per share. The price reported above reflects the weighted average sale price. The Reporting Person undertakes to provide upon request by the staff of the Securities and Exchange Commission, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price. This transaction was executed in multiple trades at prices ranging from $71.0000 to $71.7850 per share. The price reported above reflects the weighted average sale price. The Reporting Person undertakes to provide upon request by the staff of the Securities and Exchange Commission, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price. The shares subject to the option vested in full on the earlier of May 26, 2021 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. One-third of the shares subject to the option shall vested 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/ Juan Jose Chacon Quiros, by power of attorney 2021-08-09