0001398327-23-000012.txt : 20231115
0001398327-23-000012.hdr.sgml : 20231115
20231115080122
ACCESSION NUMBER: 0001398327-23-000012
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231113
FILED AS OF DATE: 20231115
DATE AS OF CHANGE: 20231115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LEWIN NICHOLAS SHERIDAN
CENTRAL INDEX KEY: 0001398327
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38593
FILM NUMBER: 231409084
MAIL ADDRESS:
STREET 1: 3 WEST 57TH ST.
STREET 2: 8TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10019
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
FISCAL YEAR END: 1231
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
wk-form4_1700053274.xml
FORM 4
X0508
4
2023-11-13
0
0001688757
ESTABLISHMENT LABS HOLDINGS INC.
ESTA
0001398327
LEWIN NICHOLAS SHERIDAN
C/O MOTIVA USA LLC
16192 COASTAL HIGHWAY
LEWES
DE
19958
1
0
0
0
0
Common Shares
2023-11-13
4
M
0
250000
18
A
1062888
D
Common Shares
9190
I
See Footnote
Stock Option (Right to buy)
18
2023-11-13
4
M
0
250000
0
D
Common Shares
250000
0
D
The shares are held by the Reporting Person's spouse.
The option, originally for 250,000 shares, vested as to one-fourth of the shares on July 18, 2019, and each subsequent one-year anniversary thereafter.
/s/ Rajbir S. Denhoy, Chief Financial Officer, by power of attorney
2023-11-15