SEC FORM D

The Securities and Exchange Commission has not necessarily reviewed the information in this filing and has not determined if it is accurate and complete.
The reader should not assume that the information is accurate and complete.

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Intentional misstatements or omissions of fact constitute federal criminal violations. See 18 U.S.C. 1001.

FORM D

Notice of Exempt Offering of Securities

OMB APPROVAL

OMB Number:			3235-0076
Estimated average burden
hours per response:			4.00

1. Issuer's Identity

CIK (Filer ID Number)

Previous Names

None

Entity Type

0001964979

ALLURION TECHNOLOGIES HOLDINGS, INC.

X	Corporation
	Limited Partnership
	Limited Liability Company
	General Partnership
	Business Trust
	Other (Specify)

Name of Issuer

ALLURION TECHNOLOGIES, INC.

Jurisdiction of Incorporation/Organization

DELAWARE

Year of Incorporation/Organization

	Over Five Years Ago
X	Within Last Five Years (Specify Year)	2023
	Yet to Be Formed

2. Principal Place of Business and Contact Information

Name of Issuer
ALLURION TECHNOLOGIES, INC.
Street Address 1		Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode	Phone Number of Issuer
NATICK	MASSACHUSETTS	01760	508-647-4000

3. Related Persons

Last Name	First Name	Middle Name
Gaur	Shantanu
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:	X	Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Gibbons	Brendan
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:	X	Executive Officer		Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Chuttani	Ram
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:	X	Executive Officer		Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Buch	Ojas
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:	X	Executive Officer		Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Ishrak	Omar
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Gupta	Krishna
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Davin	Michael
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Hudson	Larson	Douglas
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Lewin	Nicholas
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Johns	Keith
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

Last Name	First Name	Middle Name
Richey	R. Jason
Street Address 1	Street Address 2
11 HURON DR
City	State/Province/Country	ZIP/PostalCode
NATICK	MASSACHUSETTS	01760

Relationship:		Executive Officer	X	Director		Promoter

Clarification of Response (if Necessary):

4. Industry Group

Agriculture

Banking & Financial Services

Commercial Banking

Insurance

Investing

Investment Banking

Pooled Investment Fund

Is the issuer registered as
an investment company under
the Investment Company
Act of 1940?

Yes

Other Banking & Financial Services

Business Services

Energy

Coal Mining

Electric Utilities

Energy Conservation

Environmental Services

Oil & Gas

Other Energy

Health Care

Biotechnology

Health Insurance

Hospitals & Physicians

Pharmaceuticals

X	Other Health Care

Manufacturing

Real Estate

Commercial

Construction

REITS & Finance

Residential

Other Real Estate

Retailing

Restaurants

Technology

Computers

Telecommunications

Other Technology

Travel

Airlines & Airports

Lodging & Conventions

Tourism & Travel Services

Other Travel

Other

5. Issuer Size

Revenue Range
	No Revenues	No Aggregate Net Asset Value
	$1 - $1,000,000	$1 - $5,000,000
	$1,000,001 - $5,000,000	$5,000,001 - $25,000,000
	$5,000,001 - $25,000,000	$25,000,001 - $50,000,000
	$25,000,001 - $100,000,000	$50,000,001 - $100,000,000
	Over $100,000,000	Over $100,000,000
X	Decline to Disclose	Decline to Disclose
	Not Applicable	Not Applicable

6. Federal Exemption(s) and Exclusion(s) Claimed (select all that apply)

		Rule 504(b)(1) (not (i), (ii) or (iii))
		Rule 504 (b)(1)(i)
		Rule 504 (b)(1)(ii)
		Rule 504 (b)(1)(iii)
	X	Rule 506(b)
		Rule 506(c)
		Securities Act Section 4(a)(5)

Investment Company Act Section 3(c)

Section 3(c)(1)

Section 3(c)(9)

Section 3(c)(2)

Section 3(c)(10)

Section 3(c)(3)

Section 3(c)(11)

Section 3(c)(4)

Section 3(c)(12)

Section 3(c)(5)

Section 3(c)(13)

Section 3(c)(6)

Section 3(c)(14)

Section 3(c)(7)

7. Type of Filing

X	New Notice			Date of First Sale	2025-11-14				First Sale Yet to Occur
	Amendment

8. Duration of Offering

Does the Issuer intend this offering to last more than one year?

Yes

9. Type(s) of Securities Offered (select all that apply)

X	Equity	Pooled Investment Fund Interests
	Debt	Tenant-in-Common Securities
X	Option, Warrant or Other Right to Acquire Another Security	Mineral Property Securities
X	Security to be Acquired Upon Exercise of Option, Warrant or Other Right to Acquire Security	Other (describe)

10. Business Combination Transaction

Is this offering being made in connection with a business combination transaction, such as a merger, acquisition or exchange offer?

Yes

Clarification of Response (if Necessary):

11. Minimum Investment

Minimum investment accepted from any outside investor

USD

12. Sales Compensation

Recipient

Recipient CRD Number

None

Roth Capital Partners, LLC

15407

(Associated) Broker or Dealer

None

(Associated) Broker or Dealer CRD Number

None

Street Address 1

Street Address 2

888 San Clemente Dr. Suite 400

City

State/Province/Country

ZIP/Postal Code

Newport Beach

CALIFORNIA

92660

State(s) of Solicitation (select all that apply)
Check “All States” or check individual States

All States

X	Foreign/non-US

CALIFORNIA

CONNECTICUT

FLORIDA

ILLINOIS

NEVADA

NEW YORK

UTAH

13. Offering and Sales Amounts

Total Offering Amount

$5,000,000

USD

Indefinite

Total Amount Sold

$5,000,000

USD

Total Remaining to be Sold

USD

Indefinite

Clarification of Response (if Necessary):

14. Investors

Select if securities in the offering have been or may be sold to persons who do not qualify as accredited investors, and enter the number of such non-accredited investors who already have invested in the offering.

Regardless of whether securities in the offering have been or may be sold to persons who do not qualify as accredited investors, enter the total number of investors who already have invested in the offering:

15. Sales Commissions & Finder's Fees Expenses

Provide separately the amounts of sales commissions and finders fees expenses, if any. If the amount of an expenditure is not known, provide an estimate and check the box next to the amount.

Sales Commissions

$350,000

USD

Estimate

Finders' Fees

USD

Estimate

Clarification of Response (if Necessary):

The company paid the placement agent a cash fee equal to up to 7.0% of the gross proceeds from the private placement.

16. Use of Proceeds

Provide the amount of the gross proceeds of the offering that has been or is proposed to be used for payments to any of the persons required to be named as executive officers, directors or promoters in response to Item 3 above. If the amount is unknown, provide an estimate and check the box next to the amount.

USD

Estimate

Clarification of Response (if Necessary):

Signature and Submission

Please verify the information you have entered and review the Terms of Submission below before signing and clicking SUBMIT below to file this notice.

Terms of Submission

In submitting this notice, each issuer named above is:

Notifying the SEC and/or each State in which this notice is filed of the offering of securities described and undertaking to furnish them, upon written request, in the accordance with applicable law, the information furnished to offerees.*

Irrevocably appointing each of the Secretary of the SEC and, the Securities Administrator or other legally designated officer of the State in which the issuer maintains its principal place of business and any State in which this notice is filed, as its agents for service of process, and agreeing that these persons may accept service on its behalf, of any notice, process or pleading, and further agreeing that such service may be made by registered or certified mail, in any Federal or state action, administrative proceeding, or arbitration brought against the issuer in any place subject to the jurisdiction of the United States, if the action, proceeding or arbitration (a) arises out of any activity in connection with the offering of securities that is the subject of this notice, and (b) is founded, directly or indirectly, upon the provisions of: (i) the Securities Act of 1933, the Securities Exchange Act of 1934, the Trust Indenture Act of 1939, the Investment Company Act of 1940, or the Investment Advisers Act of 1940, or any rule or regulation under any of these statutes, or (ii) the laws of the State in which the issuer maintains its principal place of business or any State in which this notice is filed.

Certifying that, if the issuer is claiming a Regulation D exemption for the offering, the issuer is not disqualified from relying on Rule 504 or Rule 506 for one of the reasons stated in Rule 504(b)(3) or Rule 506(d).

Each Issuer identified above has read this notice, knows the contents to be true, and has duly caused this notice to be signed on its behalf by the undersigned duly authorized person.

For signature, type in the signer's name or other letters or characters adopted or authorized as the signer's signature.

Issuer	Signature	Name of Signer	Title	Date
ALLURION TECHNOLOGIES, INC.	/s/ Brendan Gibbons	Brendan Gibbons	Chief Legal Officer	2025-11-26

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.

* This undertaking does not affect any limits Section 102(a) of the National Securities Markets Improvement Act of 1996 ("NSMIA") [Pub. L. No. 104-290, 110 Stat. 3416 (Oct. 11, 1996)] imposes on the ability of States to require information. As a result, if the securities that are the subject of this Form D are "covered securities" for purposes of NSMIA, whether in all instances or due to the nature of the offering that is the subject of this Form D, States cannot routinely require offering materials under this undertaking or otherwise and can require offering materials only to the extent NSMIA permits them to do so under NSMIA's preservation of their anti-fraud authority.

SEC Form D filed by Allurion Technologies Inc.