0001645383-15-000002.txt : 20150720 0001645383-15-000002.hdr.sgml : 20150720 20150720120254 ACCESSION NUMBER: 0001645383-15-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150716 FILED AS OF DATE: 20150720 DATE AS OF CHANGE: 20150720 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: 3301 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 BUSINESS PHONE: 408 418 7500 MAIL ADDRESS: STREET 1: 3301 OLCOTT STREET CITY: SANTA CLARA STATE: CA ZIP: 95054 FORMER COMPANY: FORMER CONFORMED NAME: MONOLITHIC SYSTEM TECHNOLOGY INC DATE OF NAME CHANGE: 19960613 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DOMENIK STEPHEN L CENTRAL INDEX KEY: 0001189256 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-32929 FILM NUMBER: 15995434 MAIL ADDRESS: STREET 1: C/O SEVIN ROSEN FUNDS STREET 2: 13455 NOEL RD #1670 CITY: DALLAS STATE: TX ZIP: 75240 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2015-07-16 0 0000890394 MoSys, Inc. mosy 0001189256 DOMENIK STEPHEN L C/O SEVIN ROSEN FUNDS 13455 NOEL RD #1670 DALLAS TX 75240 1 0 0 0 Option to purchase Common Stock 1.7 2015-07-16 4 M 0 40000 1.7 A 2016-07-16 2021-07-16 Common Stock 40000 160000 D C. Leitner by Power of Attorney 2015-07-20