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