0001742429-20-000007.txt : 20201113 0001742429-20-000007.hdr.sgml : 20201113 20201113160422 ACCESSION NUMBER: 0001742429-20-000007 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201111 FILED AS OF DATE: 20201113 DATE AS OF CHANGE: 20201113 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chacon Quiros Juan Jose CENTRAL INDEX KEY: 0001742429 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38593 FILM NUMBER: 201311428 MAIL ADDRESS: STREET 1: C/O MOTIVA USA LLC STREET 2: 16192 COASTAL HIGHWAY CITY: LEWES STATE: DE ZIP: 19958 FORMER NAME: FORMER CONFORMED NAME: Quiros Juan Jose Chacon DATE OF NAME CHANGE: 20180601 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_160530144269459.xml FORM 4 X0306 4 2020-11-11 0 0001688757 ESTABLISHMENT LABS HOLDINGS INC. ESTA 0001742429 Chacon Quiros Juan Jose C/O MOTIVA USA LLC 16192 COASTAL HIGHWAY LEWES DE 19958 1 1 0 0 Chief Executive Officer Common Shares 2020-11-11 4 S 0 6459 26.5839 D 287781 D Common Shares 1128264 I See Footnote The sale was effected pursuant to a Rule 10b5-1 trading plan adopted by the Reporting Person. This transaction was executed in multiple trades at prices ranging from $26.25 to $27.14 per share. The price reported above reflects the weighted average sale price. The Reporting Person undertakes to provide upon request by the staff of the Securities and Exchange Commission, the Issuer, or a security holder of the Issuer, full information regarding the number of shares sold at each separate price. The shares are held by Sariel LLC. The Reporting Person is a shareholder of Sariel LLC and has voting and dispositive power over the shares owned by Sariel LLC. The Reporting Person disclaims beneficial ownership of the shares held by Sariel LLC, except to the extent of his pecuniary interest therein /s/ Renee M. Gaeta, by power of attorney 2020-11-13