0001862601-24-000004.txt : 20240528 0001862601-24-000004.hdr.sgml : 20240528 20240528172245 ACCESSION NUMBER: 0001862601-24-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240524 FILED AS OF DATE: 20240528 DATE AS OF CHANGE: 20240528 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Gillin Leslie CENTRAL INDEX KEY: 0001862601 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-38593 FILM NUMBER: 24993098 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] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 981436377 STATE OF INCORPORATION: D8 FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: BUILDING B15 AND 25 COYOL FREE ZONE CITY: ALAJUELA STATE: G2 ZIP: 20101 BUSINESS PHONE: 50624342400 MAIL ADDRESS: STREET 1: BUILDING B15 AND 25 COYOL FREE ZONE CITY: ALAJUELA STATE: G2 ZIP: 20101 4 1 wk-form4_1716931357.xml FORM 4 X0508 4 2024-05-24 0 0001688757 ESTABLISHMENT LABS HOLDINGS INC. ESTA 0001862601 Gillin Leslie C/O MOTIVA USA LLC 16192 COASTAL HIGHWAY LEWES DE 19958 1 0 0 0 0 Common Shares 2024-05-24 4 A 0 2334 0 A 9770 D Represents an award of stock units under the Issuer's 2018 Equity Incentive Plan. The shares subject to the award vest in full on the earlier of May 24, 2025 or the day prior to the date of the Issuer's next annual meeting of stockholders, subject to the Reporting Person continuing as a service provider through such date. /s/ Rajbir S. Denhoy, Chief Financial Officer, by power of attorney 2024-05-28