0000950170-24-012830.txt : 20240208
0000950170-24-012830.hdr.sgml : 20240208
20240208163500
ACCESSION NUMBER: 0000950170-24-012830
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20240206
FILED AS OF DATE: 20240208
DATE AS OF CHANGE: 20240208
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: THIEL PETER
CENTRAL INDEX KEY: 0001211060
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609634
BUSINESS ADDRESS:
STREET 1: 9200 SUNSET BOULEVARD
STREET 2: SUITE 1110
CITY: WEST HOLLYWOOD
STATE: CA
ZIP: 90069
BUSINESS PHONE: 323-990-2000
MAIL ADDRESS:
STREET 1: 9200 SUNSET BOULEVARD
STREET 2: SUITE 1110
CITY: WEST HOLLYWOOD
STATE: CA
ZIP: 90069
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mithril LP
CENTRAL INDEX KEY: 0001552273
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609639
BUSINESS ADDRESS:
STREET 1: ONE LETTERMAN DRIVE
STREET 2: BUILDING C SUITE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94129
BUSINESS PHONE: 415-248-5147
MAIL ADDRESS:
STREET 1: ONE LETTERMAN DRIVE
STREET 2: BUILDING C SUITE 400
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: MITHRIL II LP
CENTRAL INDEX KEY: 0001669609
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609636
BUSINESS ADDRESS:
STREET 1: ONE LETTERMAN DRIVE, BLDG. A, SUITE 4900
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94129
BUSINESS PHONE: (415) 659-8940
MAIL ADDRESS:
STREET 1: ONE LETTERMAN DRIVE, BLDG. A, SUITE 4900
CITY: SAN FRANCISCO
STATE: CA
ZIP: 94129
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mithril GP LP
CENTRAL INDEX KEY: 0001881891
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609635
BUSINESS ADDRESS:
STREET 1: C/O MITHRIL CAPITAL MANAGEMENT LLC
STREET 2: 600 CONGRESS AVENUE, SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
BUSINESS PHONE: 512-717-3770
MAIL ADDRESS:
STREET 1: C/O MITHRIL CAPITAL MANAGEMENT LLC
STREET 2: 600 CONGRESS AVENUE, SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mithril II UGP LLC
CENTRAL INDEX KEY: 0001878230
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609638
BUSINESS ADDRESS:
STREET 1: 600 CONGRESS AVENUE
STREET 2: SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
BUSINESS PHONE: 512-717-3770
MAIL ADDRESS:
STREET 1: 600 CONGRESS AVENUE
STREET 2: SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Mithril II GP LP
CENTRAL INDEX KEY: 0001878232
ORGANIZATION NAME:
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609637
BUSINESS ADDRESS:
STREET 1: 600 CONGRESS AVENUE
STREET 2: SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
BUSINESS PHONE: 512-717-3770
MAIL ADDRESS:
STREET 1: 600 CONGRESS AVENUE
STREET 2: SUITE 3100
CITY: AUSTIN
STATE: TX
ZIP: 78701
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Fractyl Health, Inc.
CENTRAL INDEX KEY: 0001572616
STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841]
ORGANIZATION NAME: 08 Industrial Applications and Services
IRS NUMBER: 273553477
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 17 HARTWELL AVENUE
CITY: LEXINGTON
STATE: MA
ZIP: 02421
BUSINESS PHONE: 781-902-8800
MAIL ADDRESS:
STREET 1: 17 HARTWELL AVENUE
CITY: LEXINGTON
STATE: MA
ZIP: 02421
FORMER COMPANY:
FORMER CONFORMED NAME: Fractyl Laboratories Inc.
DATE OF NAME CHANGE: 20130320
4
1
ownership.xml
4
X0508
4
2024-02-06
0001572616
Fractyl Health, Inc.
GUTS
0001552273
Mithril LP
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
0001878230
Mithril II UGP LLC
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
0001878232
Mithril II GP LP
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
0001669609
MITHRIL II LP
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
0001881891
Mithril GP LP
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
0001211060
THIEL PETER
C/O MITHRIL CAPITAL MANAGEMENT LLC
111 CONGRESS AVENUE, SUITE 500
AUSTIN
TX
78701
false
false
true
false
false
Common Stock
2024-02-06
4
C
false
5160301
A
5160301
D
Common Stock
2024-02-06
4
C
false
918567
A
918567
I
See footnote
Common Stock
2024-02-06
4
P
false
333333
15.00
A
1251900
I
See footnote
Series C-1 Preferred Stock
2024-02-06
4
C
false
4025764
D
Common Stock
1875938
0
D
Series C-2 Preferred Stock
2024-02-06
4
C
false
6502796
D
Common Stock
3030193
0
D
Series D Preferred Stock
2024-02-06
4
C
false
545450
D
Common Stock
254170
0
D
Series E Preferred Stock
2024-02-06
4
C
false
373021
D
Common Stock
173821
0
I
See footnote
Series F Preferred Stock
2024-02-06
4
C
false
1598225
D
Common Stock
744746
0
I
See footnote
In connection with the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into 0.466 shares of the Issuer's common stock in accordance with the terms of such preferred stock.
Represents securities held by Mithril LP ("LP"). Mithril GP LP ("GP LP") is the general partner of LP and may be deemed to have shared voting and dispositive power with respect to the securities held by LP. Ajay Royan, a member of the Issuer's board of directors, is the authorized person of GP LP. Mr. Royan and Peter Thiel are the members of the investment committee of GP LP, and in such capacities may be deemed to have beneficial ownership of the securities held by LP. Each of GP LP and Mr. Thiel disclaims such beneficial ownership except to the extent of its and his respective pecuniary interest therein, if any. Mr. Royan is a director of the Issuer and files separate Section 16 reports.
Represents securities held by Mithril II LP ("II LP"). Mithril II UGP LLC ("UGP II") is the general partner of Mithril II GP LP ("GP II"), which is the general partner of II LP, and each of UGP II and GP II may be deemed to have shared voting and dispositive power with respect to the securities held by II LP. Mr. Royan is the sole managing member of UGP II. Messrs. Royan and Thiel are the members of the investment committee of GP II, and in such capacities may be deemed to have beneficial ownership of the securities held by II LP. Each of UGP II, GP II and Mr. Thiel disclaims such beneficial ownership except to the extent of its and his respective pecuniary interest therein, if any. Mr. Royan is a director of the Issuer and files separate Section 16 reports.
Mithril II UGP LLC By: /s/ Ajay Royan, Managing Member
2024-02-08
Mithril II GP LP By: Mithril II UGP LLC, its general partner By: /s/ Ajay Royan, Managing Member
2024-02-08
Mithril II LP By: Mithril II GP LP, its general partner By: Mithril II UGP LLC, its general partner, By: /s/ Ajay Royan, Managing Member
2024-02-08
Mithril GP LP By: /s/ Ajay Royan, Authorized Person
2024-02-08
Mithril LP By: Mithril GP LP, its general partner By: /s/ Ajay Royan, Authorized Person
2024-02-08
/s/ Peter Thiel
2024-02-08