0001628280-18-009513.txt : 20180723
0001628280-18-009513.hdr.sgml : 20180723
20180723162920
ACCESSION NUMBER: 0001628280-18-009513
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20180723
FILED AS OF DATE: 20180723
DATE AS OF CHANGE: 20180723
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CPH TU, LP
CENTRAL INDEX KEY: 0001746422
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38593
FILM NUMBER: 18964713
BUSINESS ADDRESS:
STREET 1: 2711 CENTERVILLE ROAD
STREET 2: SUITE 400
CITY: WILMINGTON
STATE: DE
ZIP: 19808
BUSINESS PHONE: 646-998-3271
MAIL ADDRESS:
STREET 1: 2711 CENTERVILLE ROAD
STREET 2: SUITE 400
CITY: WILMINGTON
STATE: DE
ZIP: 19808
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: 000000000
STATE OF INCORPORATION: D8
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_153237774222838.xml
FORM 4
X0306
4
2018-07-23
0
0001688757
ESTABLISHMENT LABS HOLDINGS INC.
ESTA
0001746422
CPH TU, LP
2711 CENTERVILLE ROAD, SUITE 400
WILMINGTON
DE
19808
0
0
1
0
Common Shares
2018-07-23
4
C
0
7516131
A
7516131
D
Class B Ordinary Shares
2018-07-23
4
C
0
7516131
0
D
Common Shares
7516131.0
0
D
The Class B Ordinary Shares automatically converted into Common Shares on a one-for-one basis upon the closing of the Issuer's initial public offering of Common Shares and had no expiration date.
/s/ Renee Gaeta, by power of attorney
2018-07-23