0001209191-21-067470.txt : 20211202
0001209191-21-067470.hdr.sgml : 20211202
20211202135317
ACCESSION NUMBER: 0001209191-21-067470
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20211201
FILED AS OF DATE: 20211202
DATE AS OF CHANGE: 20211202
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lewis Scott Richard
CENTRAL INDEX KEY: 0001757430
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-32929
FILM NUMBER: 211465912
MAIL ADDRESS:
STREET 1: 2016 BECKETT DRIVE
CITY: EL DORADO HILLS
STATE: CA
ZIP: 95762
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MoSys, Inc.
CENTRAL INDEX KEY: 0000890394
STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674]
IRS NUMBER: 770291941
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 2309 BERING DRIVE
CITY: SAN JOSE
STATE: CA
ZIP: 95131
BUSINESS PHONE: 408 418 7500
MAIL ADDRESS:
STREET 1: 2309 BERING DRIVE
CITY: SAN JOSE
STATE: CA
ZIP: 95131
FORMER COMPANY:
FORMER CONFORMED NAME: MONOLITHIC SYSTEM TECHNOLOGY INC
DATE OF NAME CHANGE: 19960613
4
1
doc4.xml
FORM 4 SUBMISSION
X0306
4
2021-12-01
0
0000890394
MoSys, Inc.
MOSY
0001757430
Lewis Scott Richard
2309 BERING DR
SAN JOSE
CA
95131
1
0
0
0
Restricted Stock Units
2021-12-01
4
A
0
2000
A
5000
D
Restricted Stock Unit ("RSU") award granted on December 1, 2021. Each RSU represents a contingent right to receive one share of the Company's common stock once vested. The entire award vests and becomes non-forfeitable on December 1, 2022, or, if earlier, the next annual meeting of stockholders following December 1, 2021, subject to reporting person's continuous service with the Company.
In accordance with Instruction 4 to this Form, Column 5 reports only the total beneficial ownership of the "class" of derivative security reported in Column 1.
/s/ James Sullivan by power of attorney
2021-12-02