0001398327-23-000012.txt : 20231115 0001398327-23-000012.hdr.sgml : 20231115 20231115080122 ACCESSION NUMBER: 0001398327-23-000012 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20231113 FILED AS OF DATE: 20231115 DATE AS OF CHANGE: 20231115 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: 231409084 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 FISCAL YEAR END: 1231 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 wk-form4_1700053274.xml FORM 4 X0508 4 2023-11-13 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 0 Common Shares 2023-11-13 4 M 0 250000 18 A 1062888 D Common Shares 9190 I See Footnote Stock Option (Right to buy) 18 2023-11-13 4 M 0 250000 0 D Common Shares 250000 0 D The shares are held by the Reporting Person's spouse. The option, originally for 250,000 shares, vested as to one-fourth of the shares on July 18, 2019, and each subsequent one-year anniversary thereafter. /s/ Rajbir S. Denhoy, Chief Financial Officer, by power of attorney 2023-11-15