0001628280-21-005101.txt : 20210318 0001628280-21-005101.hdr.sgml : 20210318 20210318163447 ACCESSION NUMBER: 0001628280-21-005101 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210317 FILED AS OF DATE: 20210318 DATE AS OF CHANGE: 20210318 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: 21754808 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 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_161609966575517.xml FORM 4 X0306 4 2021-03-17 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 Common Shares 2021-03-17 4 P 0 350 59.97 A 350 I See Footnote Common Shares 780463 D The shares are held by the Reporting Person's spouse. /s/ Renee M. Gaeta, by power of attorney 2021-03-18