0001688757-17-000002.txt : 20170202 0001688757-17-000002.hdr.sgml : 20170202 20170202133539 ACCESSION NUMBER: 0001688757-17-000002 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170202 DATE AS OF CHANGE: 20170202 EFFECTIVENESS DATE: 20170202 FILER: COMPANY DATA: COMPANY CONFORMED NAME: ESTABLISHMENT LABS HOLDINGS INC. CENTRAL INDEX KEY: 0001688757 STANDARD INDUSTRIAL CLASSIFICATION: ORTHOPEDIC, PROSTHETIC & SURGICAL APPLIANCES & SUPPLIES [3842] IRS NUMBER: 000000000 STATE OF INCORPORATION: D8 FILING VALUES: FORM TYPE: D SEC ACT: 1933 Act SEC FILE NUMBER: 021-279905 FILM NUMBER: 17567680 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 D 1 primary_doc.xml X0707 D LIVE 0001688757 ESTABLISHMENT LABS HOLDINGS INC. COMMERCE HOUSE #3140 WICKHAMS CAY 1, ROAD TOWN TORTOLA D8 VIRGIN ISLANDS, BRITISH VG1110 50624342400 VIRGIN ISLANDS, BRITISH None None Corporation true 2013 Juan Jose Chacon Quiros C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Executive Officer Director ANTOUN NABHAN C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Executive Officer SALVADOR DADA SANTOS C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Executive Officer RUDY MAZZOCCHI C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Executive Officer Director LISA COLLERAN C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Director ED SCHUTTER C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Director ALLAN WEINSTEIN C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Director DAVID HUNG C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Director NICHOLAS LEWIN C/O ESTABLISHMENT LABS HOLDINGS INC. BUILDING 15 AND 25, COYOL FREE ZONE ALAJUELA G2 COSTA RICA 20101 Director Other Technology Decline to Disclose 06b false 2017-01-20 false true false 0 1000000 1000000 0 false 11 0 0 0 false ESTABLISHMENT LABS HOLDINGS INC. /s/ Antoun Nabhan Antoun Nabhan Chief Financial Officer 2017-02-01