0001213900-21-053537.txt : 20211019 0001213900-21-053537.hdr.sgml : 20211019 20211019170752 ACCESSION NUMBER: 0001213900-21-053537 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: Tal Lior CENTRAL INDEX KEY: 0001889113 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-40932 FILM NUMBER: 211331821 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 0001889113 Tal Lior 1015 O'BRIEN DR. MENLO PARK CA 94025 1 1 1 0 Chief Executive Officer Stock Options 0.13 2018-03-23 2028-03-22 Common Stock 953789 D Stock Options 0.13 2018-03-23 2027-04-05 Common Stock 2424215 D Stock Options 0.22 2018-05-31 2028-05-30 Common Stock 1987000 D Stock Options 2.88 2021-07-26 2031-07-25 Common Stock 1600000 D These options are fully vested. On the first year anniversary of the date of grant of July 26, 2021, 400,000 shares of the total option will vest. Thereafter, for the next 12 months, 33,333 shares shall vest monthly, such that on the second anniversary of the date of grant an additional 400,000 shares of the total option will vest. Thereafter, for the next 48 months 16,667 shares of the option will vest monthly until the option is fully vested on the 6th anniversary of the date of grant. /s/ Lior Tal 2021-10-19