0001213900-21-054211.txt : 20211022
0001213900-21-054211.hdr.sgml : 20211022
20211022163118
ACCESSION NUMBER: 0001213900-21-054211
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211022
FILED AS OF DATE: 20211022
DATE AS OF CHANGE: 20211022
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: LASKY MITCHELL
CENTRAL INDEX KEY: 0001091435
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372]
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0331
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-40932
FILM NUMBER: 211340895
MAIL ADDRESS:
STREET 1: 2480 SAND HILL ROAD
STREET 2: STE 200
CITY: MENLO PARK
STATE: CA
ZIP: 94025
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: Cyngn, Inc.
CENTRAL INDEX KEY: 0001874097
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371]
IRS NUMBER: 462007094
STATE OF INCORPORATION: DE
BUSINESS ADDRESS:
STREET 1: 1015 O'BRIEN DRIVE
CITY: MENLO PARK
STATE: CA
ZIP: 94025
BUSINESS PHONE: 650-924-5905
MAIL ADDRESS:
STREET 1: 1015 O'BRIEN DRIVE
CITY: MENLO PARK
STATE: CA
ZIP: 94025
4
1
ownership.xml
OWNERSHIP DOCUMENT
X0306
4
2021-10-22
0
0001874097
Cyngn, Inc.
CYN
0001091435
LASKY MITCHELL
2965 WOODSIDE ROAD
WOODSIDE
CA
94062
1
0
1
0
Common Stock
2021-10-22
4
C
0
8038585
A
8038585
I
See footnotes
Common Stock
2021-10-22
4
C
0
692418
A
8731003
I
See footnotes
Common Stock
2021-10-22
4
C
0
217622
A
8948625
I
See footnotes
Common Stock
2021-10-22
4
C
0
290162
A
290162
I
See footnotes
Series A Preferred Stock
2021-10-22
4
C
0
8038585
0.00
D
Common Stock
8038585
0
I
See footnotes
Series B Preferred Stock
2021-10-22
4
C
0
692418
0.00
D
Common Stock
692418
0
I
See footnotes
Series C Preferred Stock
2021-10-22
4
C
0
217622
0.00
D
Common Stock
217622
0
I
See footnotes
Series C Preferred Stock
2021-10-22
4
C
0
290162
0.00
D
Common Stock
290162
0
I
See footnotes
All Series of convertible Preferred Stock automatically converted into shares of the Company's Common Stock on a 1-for-1 basis, without payment or further consideration, immediately prior to the consummation of the Company's initial public offering.
The shares are held by Benchmark Capital Partners VII, L.P. ("BCP VII"), for itself and as nominee for Benchmark Founders' Fund VII, L.P. ("BFF VII") and Benchmark Founders' Fund VII-B, L.P. ("BFF VII-B"). Benchmark Capital Management Co. VII, L.L.C. ("BCMC VII"), the general partner of each of BCP VII, BFF VII and BFF VII-B, may be deemed to have sole voting and dispositive power over such shares. Matthew R. Cohler, Bruce W. Dunlevie, Peter H. Fenton, J. William Gurley, Kevin R. Harvey, Mitchell H. Lasky (a member of the Issuer's board of directors) and Steven M. Spurlock, the managing members of BCMC VII, may be deemed to share voting and dispositive power over these shares beneficially held by such entities. Each such person and entity disclaims the existence of a "group" and disclaims beneficial ownership of any securities, except to the extent of such person's or entity's pecuniary interest in such securities.
The shares are held by Benchmark Capital Partners VI, L.P. ("BCP VI"), for itself and as nominee for Benchmark Founders' Fund VI, L.P. ("BFF VI"), Benchmark Founders' Fund VI-B, L.P. ("BFF VI-B") and related persons. Benchmark Capital Management Co. VI, L.L.C. ("BCMC VI"), the general partner of each of BCP VI, BFF VI and BFF VI-B, may be deemed to have sole voting and dispositive power over such shares. Alexandre Balkanski, Matthew R. Cohler, Bruce W. Dunlevie, Peter H. Fenton, J. William Gurley, Kevin R. Harvey, Robert C. Kagle, Mitchell H. Lasky (a member of the Issuer's board of directors) and Steven M. Spurlock, the managing members of BCMC VI, may be deemed to share voting and dispositive power over these shares beneficially held by such entities. Each such person and entity disclaims the existence of a "group" and disclaims beneficial ownership of any securities, except to the extent of such person or entity's pecuniary interest in such securities.
/s/ An-Yen Hu, by power of attorney for Mitchell Lasky
2021-10-22