0001104659-24-012328.txt : 20240208
0001104659-24-012328.hdr.sgml : 20240208
20240208164933
ACCESSION NUMBER: 0001104659-24-012328
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: AMERICAN HOME ASSURANCE CO
CENTRAL INDEX KEY: 0000005181
ORGANIZATION NAME:
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-41942
FILM NUMBER: 24609838
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
tm245543-1_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2024-02-06
1
0001572616
Fractyl Health, Inc.
GUTS
0000005181
AMERICAN HOME ASSURANCE CO
1271 AVENUE OF THE AMERICAS
NEW YORK
NY
10020-1304
0
0
1
0
0
Common Stock
2024-02-06
4
C
0
283878
A
283878
D
Series E Preferred Shares
2024-02-06
4
C
0
494173
0
D
Common Stock
230276
0
D
Series F Preferred Shares
2024-02-06
4
C
0
115030
0
D
Common Stock
53602
0
D
The Series E Convertible Preferred Stock and Series F Convertible Preferred Stock (together, the "Preferred Shares") automatically converted into shares of the Issuer's common stock, for no additional consideration, immediately prior to the closing of the Issuer's initial public offering of common stock, at a conversion ratio of 1 share of Common Stock for 2.146 Preferred Shares. The Preferred Shares had no expiration date.
American Home Assurance Company is a wholly owned, indirect subsidiary of American International Group, Inc.
/s/ Tanya Kent, Secretary
2024-02-08