0000899243-15-001378.txt : 20150717 0000899243-15-001378.hdr.sgml : 20150717 20150717175100 ACCESSION NUMBER: 0000899243-15-001378 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150715 FILED AS OF DATE: 20150717 DATE AS OF CHANGE: 20150717 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHIASMA, INC CENTRAL INDEX KEY: 0001339469 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 831 BEACON STREET STREET 2: SUITE 313 CITY: NEWTON CENTRE STATE: MA ZIP: 02459 BUSINESS PHONE: 914-234-2268 MAIL ADDRESS: STREET 1: 831 BEACON STREET STREET 2: SUITE 313 CITY: NEWTON CENTRE STATE: MA ZIP: 02459 FORMER COMPANY: FORMER CONFORMED NAME: CHIASMA INC DATE OF NAME CHANGE: 20050922 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: F2 Capital I 2014 Ltd CENTRAL INDEX KEY: 0001648355 STATE OF INCORPORATION: D8 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37500 FILM NUMBER: 15994671 BUSINESS ADDRESS: STREET 1: PO BOX 3175, ROAD TOWN CITY: TORTOLA STATE: D8 ZIP: 1110 BUSINESS PHONE: 44(0) 1624 811 611 MAIL ADDRESS: STREET 1: C/O LJ SKYE TRUSTEES LTD. STREET 2: COMMERCE HOUSE, 1 BOWRING ROAD CITY: RAMSEY STATE: Y8 ZIP: IM8 2LQ REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LJ Skye Trustees Ltd. CENTRAL INDEX KEY: 0001648354 STATE OF INCORPORATION: Y8 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37500 FILM NUMBER: 15994672 BUSINESS ADDRESS: STREET 1: COMMERCE HOUSE, 1 BOWRING ROAD CITY: RAMSEY STATE: Y8 ZIP: IM8 2LQ BUSINESS PHONE: 44(0) 1624 811 611 MAIL ADDRESS: STREET 1: COMMERCE HOUSE, 1 BOWRING ROAD CITY: RAMSEY STATE: Y8 ZIP: IM8 2LQ REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Globeways Holdings Ltd CENTRAL INDEX KEY: 0001600769 STATE OF INCORPORATION: D8 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-37500 FILM NUMBER: 15994673 BUSINESS ADDRESS: STREET 1: 3RD FLOOR, GENEVE PLACE STREET 2: WATERFRONT DRIVE, PO BOX 3175 CITY: ROAD TOWN, TORTOLA STATE: D8 ZIP: 00000 BUSINESS PHONE: 617-951-8000 MAIL ADDRESS: STREET 1: 3RD FLOOR, GENEVE PLACE STREET 2: WATERFRONT DRIVE, PO BOX 3175 CITY: ROAD TOWN, TORTOLA STATE: D8 ZIP: 00000 3/A 1 doc3a.xml FORM 3/A SUBMISSION X0206 3/A 2015-07-15 2015-07-15 0 0001339469 CHIASMA, INC CHMA 0001600769 Globeways Holdings Ltd 3RD FLOOR, GENEVE PLACE, WATERFRONT DR PO BOX 3175, ROAD TOWN TORTOLA D8 VIRGIN ISLANDS, BRITISH 0 0 1 0 0001648354 LJ Skye Trustees Ltd. COMMERCE HOUSE 1 BOWRING ROAD RAMSEY Y8 IM8 2LQ ISLE OF MAN 0 0 1 0 0001648355 F2 Capital I 2014 Ltd PO BOX 3175, ROAD TOWN TORTOLA D8 VIRGIN ISLANDS, BRITISH 0 0 1 0 Series D' Convertible Preferred Stock Common Stock 36501 D Series E Convertible Preferred Stock Common Stock 1478318 I See Footnote Series E Convertible Preferred Stock Common Stock 9249 D Warrant to Purchase Common Stock (right to buy) 9.132 Common Stock 369579 I See Footnote Warrant to Purchase Common Stock (right to buy) 9.132 Common Stock 2312 D The Series D' Convertible Preferred Stock is convertible into Common Stock on a 9.132-for-1 basis into the number of shares of Common Stock as shown in column 3 at any time at the holder's election, and automatically upon the closing of the Issuer's initial public offering, and has no expiration date. The reported securities are owned directly by F2 Capital I 2014 Limited. Globeways Holdings Limited is a member of F2 Capital 1 2014 Limited and has sole power to vote upon the acquisition, holding and disposal of all shares and warrants held by F2 Capital 1 2014 Limited. LJ Skye Trustees Ltd. has the sole power to vote upon the acquisition, holding and disposal of all shares and warrants held by Globeways Holdings Limited. Each of the reporting persons disclaims beneficial ownership of the securities reported herein except to the extent of their pecuniary interest therein. The Series E Convertible Preferred Stock is convertible into Common Stock on a 9.132-for-1 basis into the number of shares of Common Stock as shown in column 3 at any time at the holder's election, and automatically upon the closing of the Issuer's initial public offering, and has no expiration date The Warrant to purchase Common Stock as shown in column 3 is exercisable at any time at the holder's election. This amendment amends the Form 3 filed on July 15, 2015 and is made solely to add additional Reporting Persons. /s/ Mark Veale for Globeways Holdings Limited 2015-07-17 /s/ Mark Veale for F2 Capital I 2014 Limited 2015-07-17 /s/ Mark Veale for LJ Skye Trustees Ltd. 2015-07-17