SEC Form 4 · accession 0001628280-18-009512
ESTABLISHMENT LABS HOLDINGS INC. · ESTA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Nicholas Sheridan Lewin
Director · 10% Owner
Period of report
Jul 23, 2018
Accepted (ET)
Jul 23, 2018 · 4:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001688757
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common SharesF1,F2 | Jul 23, 2018 | C | 7,516,131 | — | A | 7,516,131 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Class B Ordinary SharesF2,F1 | — | Jul 23, 2018 | C | 7,516,131 | D | — | — | Common Shares | 7,516,131 | 0 | I |
Explanation of responses
- F1The Class B Ordinary Shares automatically converted into Common Shares on a one-for-one basis upon the closing of the Issuer's initial public offering of Common Shares and had no expiration date.
- F2The shares are held by CPH TU, LP, of which the Reporting Person is a managing partner. The Reporting Person disclaims beneficial ownership of the shares held by CPH TU, LP, except to the extent of his pecuniary interest therein.