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