Initial Statement of Beneficial Ownership (3)
April 22 2020 - 5:13PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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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
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Varadan Anand |
2. Date of Event Requiring Statement (MM/DD/YYYY)
4/22/2020
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3. Issuer Name and Ticker or Trading Symbol
CHIASMA, INC [CHMA]
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(Last)
(First)
(Middle)
C/O CHIASMA, INC., 140 KENDRICK STREET, BUILDING C |
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director _____ 10% Owner ___X___ Officer (give title below) _____ Other (specify below) EVP, Chief Commerical Officer / |
(Street)
NEEDHAM, MA 02494
(City)
(State)
(Zip)
| 5. If Amendment, Date Original Filed(MM/DD/YYYY)
| 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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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)
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1. Title of Derivate Security (Instr. 4) | 2. Date Exercisable and Expiration Date (MM/DD/YYYY) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) |
Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Stock Option (Right to Buy) | 2/23/2018 (1) | 2/23/2028 | Common Stock | 36069 | $1.52 | D | |
Stock Option (Right to Buy) | 2/14/2019 (1) | 2/14/2029 | Common Stock | 13692 | $3.75 | D | |
Stock Option (Right to Buy) | 10/15/2019 (2) | 10/15/2029 | Common Stock | 112441 | $4.84 | D | |
Explanation of Responses: |
(1) | The shares of Common Stock underlying the option vested in equal quarterly installments over one (1) year from the date of grant. |
(2) | 25% of the shares of Common Stock underlying the option vested on January 1, 2020 and the remaining shares will vest in three equal quarterly installments thereafter. |
Remarks: Exhibit 24.1 Power of Attorney |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
Varadan Anand C/O CHIASMA, INC. 140 KENDRICK STREET, BUILDING C NEEDHAM, MA 02494 |
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| EVP, Chief Commerical Officer |
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Signatures
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Mark Fitzpatrick, as Attorney-in-Fact | | 4/22/2020 |
**Signature of Reporting Person | Date |
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