0001209191-19-037509.txt : 20190617
0001209191-19-037509.hdr.sgml : 20190617
20190617185531
ACCESSION NUMBER: 0001209191-19-037509
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 2
CONFORMED PERIOD OF REPORT: 20190617
FILED AS OF DATE: 20190617
DATE AS OF CHANGE: 20190617
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: KANNAN RAJ
CENTRAL INDEX KEY: 0001778539
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-37500
FILM NUMBER: 19902349
MAIL ADDRESS:
STREET 1: C/O CHIASMA, INC. 460 TOTTEN POND RD
STREET 2: SUITE 530
CITY: WALTHAM
STATE: MA
ZIP: 02451
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: 460 TOTTEN POND ROAD
STREET 2: SUITE 530
CITY: WALTHAM
STATE: MA
ZIP: 02451
BUSINESS PHONE: 617-928-5300
MAIL ADDRESS:
STREET 1: 460 TOTTEN POND ROAD
STREET 2: SUITE 530
CITY: WALTHAM
STATE: MA
ZIP: 02451
FORMER COMPANY:
FORMER CONFORMED NAME: CHIASMA INC
DATE OF NAME CHANGE: 20050922
3
1
doc3.xml
FORM 3 SUBMISSION
X0206
3
2019-06-17
0
0001339469
CHIASMA, INC
CHMA
0001778539
KANNAN RAJ
C/O CHIASMA, INC.
460 TOTTEN POND ROAD, SUITE 530
WALTHAM
MA
02451
1
1
0
0
Chief Executive Officer
Common Stock
7095
D
Exhibit 24.1 Power of Attorney
/s/ Mark J. Fitzpatrick, Attorney-in-Fact
2019-06-17
EX-24.3_860533
2
poa.txt
POA DOCUMENT
POWER OF ATTORNEY
Know all by these presents, that the undersigned hereby constitutes and
appoints each of Mark Fitzpatrick and Drew Enamait, signing singly, the
undersigned's true and lawful attorney-in-fact to:
(1) execute for and on behalf of the undersigned, in the undersigned's
capacity as an officer and/or director of Chiasma, Inc. (the
"Company"), Forms 3, 4 and 5 and amendments thereto in accordance
with Section 16(a) of the Securities Exchange Act of 1934, as
amended, and the rules thereunder;
(2) do and perform any and all acts for and on behalf of the
undersigned which may be necessary or desirable to complete and
execute any such Form 3, 4 or 5 and amendments thereto and timely
file such form with the United States Securities and Exchange
Commission and any stock exchange or similar authority; and
(3) take any other action of any type whatsoever in connection with the
foregoing which, in the opinion of such attorney-in-fact, may be of
benefit to, in the best interest of, or legally required by, the
undersigned, it being understood that the documents executed by
such attorney-in-fact on behalf of the undersigned pursuant to this
Power of Attorney shall be in such form and shall contain such
terms and conditions as such attorney-in-fact may approve in such
attorney-in-fact's discretion.
The undersigned hereby grants to each such attorney-in-fact full power
and authority to do and perform any and every act and thing whatsoever
requisite, necessary, or proper to be done in the exercise of any of the rights
and powers herein granted, as fully to all intents and purposes as the
undersigned might or could do if personally present, with full power of
substitution or revocation, hereby ratifying and confirming all that such
attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall
lawfully do or cause to be done by virtue of this Power of Attorney and the
rights and powers herein granted. The undersigned acknowledges that the
foregoing attorneys-in-fact, in serving in such capacity at the request of the
undersigned, are not assuming, nor is the Company assuming, any of the
undersigned's responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934, as amended. The undersigned hereby agrees to indemnify
the attorney-in-fact and the Company from and against any demand, damage, loss,
cost or expense arising from any false or misleading information provided by the
undersigned to the attorney-in-fact.
This Power of Attorney shall remain in full force and effect until the
undersigned is no longer required to file Forms 3, 4 and 5 with respect to the
undersigned's holdings of and transactions in securities issued by the Company,
unless earlier revoked by the undersigned in a signed writing delivered to the
foregoing attorneys-in-fact. This Power of Attorney may be filed with the
United States Securities and Exchange Commission as a confirming statement of
the authority granted herein. This Power of Attorney supersedes any prior power
of attorney in connection with the undersigned's capacity as an officer and/or
director of the Company. This Power of Attorney shall expire as to any
individual attorney-in-fact if such attorney-in-fact ceases to be an executive
officer of the Company.
IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to
be executed as of May 25, 2019.
/s/ Raj Kannan
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Signature
Raj Kannan
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Print Name