SEC FORM 3

SEC Form 3

FORM 3

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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^*

Mamluk Roni

(Last)

(First)

(Middle)

C/O CHIASMA, INC.

60 WELLS AVENUE, SUITE 102

(Street)

NEWTON

02459

(City)

(State)

(Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
07/15/2015

3. Issuer Name and Ticker or Trading Symbol
CHIASMA, INC [ CHMA ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

	Director	10% Owner
X	Officer (give title below)	Other (specify below)
	Chief Development Officer

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

X	Form filed by One Reporting Person
	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Beneficially Owned
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)
1. Title of Derivative Security (Instr. 4)	2. Date Exercisable and Expiration Date (Month/Day/Year)		3. Title and Amount of Securities Underlying Derivative Security (Instr. 4)		4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
1. Title of Derivative Security (Instr. 4)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	4. Conversion or Exercise Price of Derivative Security	5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5)	6. Nature of Indirect Beneficial Ownership (Instr. 5)
Stock Option (right to buy)	⁽¹⁾	10/14/2018	Common Stock	9,556	$0.09	D
Stock Option (right to buy)	⁽²⁾	09/20/2021	Common Stock	151,139	$0.09	D
Stock Option (right to buy)	⁽³⁾	09/12/2022	Common Stock	82,186	$0.09	D
Stock Option (right to buy)	⁽⁴⁾	11/15/2024	Common Stock	225,689	$3.29	D
Stock Option (right to buy)	⁽⁵⁾	04/13/2025	Common Stock	213,345	$5.57	D

Explanation of Responses:

1. This option is fully vested and exercisable.

2. This option vests over a four-year period at a rate of twenty-five percent (25%) on September 7, 2012 and in 12 equal quarterly installments thereafter.

3. This option vests over a four-year period at a rate of twenty-five percent (25%) on September 12, 2013 and in 12 equal quarterly installments thereafter.

4. This option vests over a four-year period in 48 equal monthly installments which began on October 21, 2014.

5. This option vests over a four-year period in 48 equal monthly installments which began on April 14, 2015.

Remarks:

Exhibit List: Exhibit 24.1 - Power of Attorney

	/s/ Mark J. Fitzpatrick, Attorney-in-Fact	07/15/2015
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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.