0000950170-24-012838.txt : 20240208
0000950170-24-012838.hdr.sgml : 20240208
20240208163735
ACCESSION NUMBER: 0000950170-24-012838
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: Royan Ajay
CENTRAL INDEX KEY: 0001875614
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609693
MAIL ADDRESS:
STREET 1: 303 WYMAN STREET
STREET 2: SUITE 300
CITY: WALTHAM
STATE: MA
ZIP: 02451
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
0001875614
Royan Ajay
C/O FRACTYL HEALTH, INC.
17 HARTWELL AVENUE
LEXINGTON
MA
02421
true
false
true
false
false
Common Stock
2024-02-06
4
C
false
5160301
A
5160301
I
See footnote
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
I
See footnote
Series C-2 Preferred Stock
2024-02-06
4
C
false
6502796
D
Common Stock
3030193
0
I
See footnote
Series D Preferred Stock
2024-02-06
4
C
false
545450
D
Common Stock
254170
0
I
See footnote
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. The Reporting Person is the authorized person of GP LP and a member of the investment committee of GP LP, and in such capacity may be deemed to have beneficial ownership of the securities held by LP. The Reporting Person disclaims such beneficial ownership except to the extent of his pecuniary interest therein, if any.
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. The Reporting Person is the sole managing member of UGP II and a member of the investment committee of GP II, and in such capacity may be deemed to have beneficial ownership of the securities held by II LP. The Reporting Person disclaim such beneficial ownership except to the extent of his pecuniary interest therein, if any.
/s/ Lisa A. Davidson as Attorney-in-Fact for Ajay Royan
2024-02-08