0001688757-17-000007.txt : 20170217 0001688757-17-000007.hdr.sgml : 20170217 20170217172614 ACCESSION NUMBER: 0001688757-17-000007 CONFORMED SUBMISSION TYPE: D PUBLIC DOCUMENT COUNT: 1 ITEM INFORMATION: 06b FILED AS OF DATE: 20170217 DATE AS OF CHANGE: 20170217 EFFECTIVENESS DATE: 20170217 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: 021-280982 FILM NUMBER: 17622459 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 BOX 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 2017-02-13 false true false 0 17274999 5301626 11973373 false 4 0 0 0 false ESTABLISHMENT LABS HOLDINGS INC. /s/ Antoun Nabhan Antoun Nabhan Chief Financial Officer 2017-02-17