0001398327-22-000006.txt : 20221214 0001398327-22-000006.hdr.sgml : 20221214 20221214161705 ACCESSION NUMBER: 0001398327-22-000006 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20221212 FILED AS OF DATE: 20221214 DATE AS OF CHANGE: 20221214 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: 221462316 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_167105260683679.xml FORM 4 X0306 4 2022-12-12 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 Stock Option (Right to buy) 71.49 2022-12-12 4 A 0 7829 0 A 2032-12-12 Common Shares 7829.0 7829 D This option was granted for consulting services the Reporting Person performs for the Registrant in addition to his services as a non-employee director. The shares subject to the option shall vest in full on December 12, 2023, subject to the Reporting Person continuing as a service provider through such date. /s/ Rajbir S. Denhoy, by power of attorney 2022-12-14