0001213900-21-053535.txt : 20211019 0001213900-21-053535.hdr.sgml : 20211019 20211019170614 ACCESSION NUMBER: 0001213900-21-053535 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211019 FILED AS OF DATE: 20211019 DATE AS OF CHANGE: 20211019 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Alvarez Donald CENTRAL INDEX KEY: 0001888950 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40932 FILM NUMBER: 211331809 MAIL ADDRESS: STREET 1: 1015 O'BRIEN DRIVE 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: 1012 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 BUSINESS PHONE: 650-924-5905 MAIL ADDRESS: STREET 1: 1012 O'BRIEN DRIVE CITY: MENLO PARK STATE: CA ZIP: 94025 3 1 ownership.xml X0206 3 2021-10-19 0 0001874097 Cyngn, Inc. CYN 0001888950 Alvarez Donald 1015 O'BRIEN DR. MENLO PARK CA 94025 0 1 0 0 Chief Financial Officer Stock Option 2.88 2031-06-01 Common Stock 400000 D 25% of the grant or 100,000 stock options, vest after the one year anniversary of the date of grant of June 1, 2021 with the remainder vesting monthly thereafter in equal amounts over three years. /s/ Donald Alvarez 2021-10-19