0000950170-24-040179.txt : 20240402 0000950170-24-040179.hdr.sgml : 20240402 20240402162012 ACCESSION NUMBER: 0000950170-24-040179 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240401 FILED AS OF DATE: 20240402 DATE AS OF CHANGE: 20240402 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kimber Adrian CENTRAL INDEX KEY: 0002016940 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-41942 FILM NUMBER: 24814514 MAIL ADDRESS: STREET 1: C/O FRACTLY HEALTH, INC. STREET 2: 3 VAN DE GRAAFF DRIVE, SUITE 200 CITY: BURLINGTON STATE: MA ZIP: 01803 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: 3 VAN DE GRAAFF DRIVE STREET 2: SUITE 200 CITY: BURLINGTON STATE: MA ZIP: 01803 BUSINESS PHONE: 781-902-8800 MAIL ADDRESS: STREET 1: 3 VAN DE GRAAFF DRIVE STREET 2: SUITE 200 CITY: BURLINGTON STATE: MA ZIP: 01803 FORMER COMPANY: FORMER CONFORMED NAME: Fractyl Health, Inc. DATE OF NAME CHANGE: 20210617 FORMER COMPANY: FORMER CONFORMED NAME: Fractyl Laboratories Inc. DATE OF NAME CHANGE: 20130320 4 1 ownership.xml 4 X0508 4 2024-04-01 0001572616 FRACTYL HEALTH, INC. GUTS 0002016940 Kimber Adrian 3 VAN DE GRAAFF DRIVE, SUITE 200 BURLINGTON MA 01803 false true false false Chief Commercial Officer false Stock Option 7.45 2024-04-01 4 A false 250000 0 A 2034-03-31 Common Stock 250000 250000 D The stock option vests and becomes exercisable as to 25% of the underlying shares on April 1, 2025 and the remaining 75% of the underlying shares in 36 equal monthly installments thereafter, subject to the Reporting Person's continued service to the Issuer through the applicable vesting date. /s/ Lisa A. Davidson, Attorney-in-fact 2024-04-02