SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person^*

Caplan Jay David

(Last)

(First)

(Middle)

17 HARTWELL AVENUE

(Street)

LEXINGTON

02421

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
02/01/2024

3. Issuer Name and Ticker or Trading Symbol
Fractyl Health, Inc. [ GUTS ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	President, Chief Product Off.

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4)	2. Amount of Securities Beneficially Owned (Instr. 4)	3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	4. Nature of Indirect Beneficial Ownership (Instr. 5)

Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Series B Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	82,817	⁽¹⁾	I	By Family Trust
Series C-1 Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	20,843	⁽¹⁾	I	By Family Trust
Series C-2 Preferred Stock	⁽¹⁾	⁽¹⁾	Common Stock	15,150	⁽¹⁾	I	By Family Trust
Stock Option	⁽²⁾	11/11/2024	Common Stock	95,484	$1.7	D
Stock Option	⁽²⁾	02/10/2025	Common Stock	61,742	$1.7	D
Stock Option	⁽²⁾	12/17/2025	Common Stock	145,875	$2.67	D
Stock Option	⁽²⁾	06/27/2026	Common Stock	23,298	$2.67	D
Stock Option	⁽²⁾	03/14/2028	Common Stock	94,879	$3.35	D
Stock Option	⁽³⁾	03/26/2030	Common Stock	12,824	$3.89	D
Stock Option	⁽⁴⁾	06/24/2031	Common Stock	38,974	$6.98	D
Stock Option	⁽⁵⁾	09/07/2032	Common Stock	11,649	$8.59	D
Stock Option	⁽⁶⁾	03/16/2033	Common Stock	25,628	$8.18	D
Stock Option	⁽⁷⁾	11/10/2033	Common Stock	14,701	$11.21	D
Restricted Stock Units	⁽⁸⁾	⁽⁸⁾	Common Stock	187,257	⁽⁸⁾	D

Explanation of Responses:

1. Each share of the Issuer's preferred stock is convertible into shares of the Issuer's common stock at the holder's election in accordance with the terms of such preferred stock and has no expiration date. The preferred stock will automatically convert into common stock upon the closing of the Issuer's initial public offering.

2. The stock option is fully vested and currently exercisable.

3. The stock option vests in 48 monthly installments beginning on April 26, 2020.

4. The stock option vests in 48 monthly installments beginning on July 24, 2021.

5. The stock option vests in 48 monthly installments beginning on October 7, 2022.

6. The stock option vests in 48 monthly installments beginning on April 16, 2023.

7. The stock option vests in 4 annual installments beginning on December 10, 2024.

8. Each restricted stock unit represents a contingent right to receive one share of the Issuer's common stock. The restricted stock units will vest on November 10, 2024 and have no expiration date.

Remarks:

Exhibit 24 - Power of Attorney.

	/s/ Lisa A. Davidson, Attorney-in-fact	02/01/2024
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.