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