0001742428-21-000001.txt : 20210217
0001742428-21-000001.hdr.sgml : 20210217
20210217163132
ACCESSION NUMBER: 0001742428-21-000001
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210212
FILED AS OF DATE: 20210217
DATE AS OF CHANGE: 20210217
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Gaeta Renee
CENTRAL INDEX KEY: 0001742428
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-38593
FILM NUMBER: 21645283
MAIL ADDRESS:
STREET 1: C/O MOTIVA USA LLC
STREET 2: 16192 COASTAL HIGHWAY
CITY: LEWES
STATE: DE
ZIP: 19958
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_161359744123497.xml
FORM 4
X0306
4
2021-02-12
0
0001688757
ESTABLISHMENT LABS HOLDINGS INC.
ESTA
0001742428
Gaeta Renee
C/O MOTIVA USA LLC
16192 COASTAL HIGHWAY
LEWES
DE
19958
0
1
0
0
Chief Financial Officer
Stock Option (Right to buy)
69.49
2021-02-12
4
A
0
12401
0
A
2031-02-15
Common Shares
12401.0
12401
D
One-fourth of the shares subject to the option shall vest on February 15, 2022 and each one-year anniversary thereafter, subject to the Reporting Person continuing as a service provider through each such date.
/s/ Renee Gaeta
2021-02-17