SEC Form 4/A · accession 0001742429-19-000002
ESTABLISHMENT LABS HOLDINGS INC. · ESTA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Quiros Juan Jose Chacon
Officer — Chief Executive Officer · Director
Period of report
Jul 23, 2018
Accepted (ET)
Jan 22, 2019 · 4:38 pm EST
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 | 57,214 | — | A | 1,185,478 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock AwardF1,F2 | — | Jul 23, 2018 | C | 57,214 | D | — | Sep 9, 2019 | Common Shares | 57,214 | 0 | D |
Explanation of responses
- F1The Restricted Stock Award was originally exercisable for Class A Ordinary Shares. The Class A Ordinary Shares automatically converted into Common Shares on a one-for-one basis immediately prior to the closing of the Issuer's initial public offering of Common Shares (the "IPO"). Upon the closing of the IPO, the Restricted Stock Award became exercisable for Common Shares. The original Form 4 filing did not reflect that the Restricted Stock Award is exercisable for Common Shares.
- F2Of these shares, 294,240 were originally granted as Restricted Stock Awards, of which 237,026 have been released as of July 23, 2018. The 294,240 share grant vested as to one half of the shares on September 9, 2016 and as to 1/72nd of the shares each month thereafter, subject to the Reporting Person continuing as a service provider through each such date.