0000950170-24-012836.txt : 20240208
0000950170-24-012836.hdr.sgml : 20240208
20240208163724
ACCESSION NUMBER: 0000950170-24-012836
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: Caplan Jay David
CENTRAL INDEX KEY: 0001419217
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609689
MAIL ADDRESS:
STREET 1: 34 CLARK STREET
CITY: BELMONT
STATE: MA
ZIP: 02478
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
0001419217
Caplan Jay David
17 HARTWELL AVENUE
LEXINGTON
MA
02421
false
true
false
false
President, Chief Product Off.
false
Common Stock
2024-02-06
4
C
false
23299
A
358806
I
By Trust
Common Stock
2024-02-06
4
C
false
118810
A
118810
I
By Family Trust
Series A Preferred Stock
2024-02-06
4
C
false
50000
D
Common Stock
23299
0
I
By Trust
Series B Preferred Stock
2024-02-06
4
C
false
177726
D
Common Stock
82817
0
I
By Family Trust
Series C-1 Preferred Stock
2024-02-06
4
C
false
44730
D
Common Stock
20843
0
I
By Family Trust
Series C-2 Preferred Stock
2024-02-06
4
C
false
32514
D
Common Stock
15150
0
I
By Family Trust
In connection with the closing of the Issuer's initial public offering, each share of preferred stock automatically converted into common stock in accordance with the terms of such preferred stock.
The Reporting Person's Form 3 filed on February 1, 2024 inadvertently omitted the securities held by the Jay D. Caplan 2021 Irrevocable Trust.
/s/ Lisa A. Davidson, Attorney-in-fact
2024-02-08