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