0001213900-21-060335.txt : 20211117 0001213900-21-060335.hdr.sgml : 20211117 20211117163022 ACCESSION NUMBER: 0001213900-21-060335 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211116 FILED AS OF DATE: 20211117 DATE AS OF CHANGE: 20211117 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Macleod Karen M CENTRAL INDEX KEY: 0001218775 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40932 FILM NUMBER: 211420938 MAIL ADDRESS: STREET 1: C/O TRACK GROUP, INC. STREET 2: 200 E 5TH AVENUE STE 100 CITY: NAPERVILLE STATE: IL ZIP: 60563 FORMER NAME: FORMER CONFORMED NAME: FERGUSON KAREN M DATE OF NAME CHANGE: 20030213 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 FORMER COMPANY: FORMER CONFORMED NAME: Cyngn, Inc. DATE OF NAME CHANGE: 20210721 4 1 ownership.xml X0306 4 2021-11-16 0 0001874097 Cyngn Inc. CYN 0001218775 Macleod Karen M 1015 O'BRIEN DR. MENLO PARK CA 94025 1 0 0 0 Stock Option (right to buy) 6.88 2021-11-16 4 A 0 19737 0.00 A 2021-11-16 2031-11-15 Common Stock 19737 19737 D /s/ Karen Macleod 2021-11-17