Andreessen Horowitz Fund III, L.P. - 22 Oct 2021 Form 4 Insider Report for Cyngn, Inc. (CYN)

Source evidence Original filing metadata and source links for verification. 4 source fields
SEC form
4
Accepted by SEC
22 Oct 2021, 16:33:19 UTC
Prior SEC filing
19 Oct 2021
Source filing
View source filing
Reporting owner 1 detail
Reporting owner signature
Andreessen Horowitz Fund III, L.P., By: AH Equity Partners III, L.L.C., Its: General Partner, By: /s/ Scott Kupor, Scott Kupor, Chief Operating Officer

Key filing fact

Andreessen Horowitz Fund III, L.P. filed Form 4 for Cyngn, Inc. (CYN) on 22 Oct 2021.

Key facts

  • This page summarizes Andreessen Horowitz Fund III, L.P.'s Form 4 filing for Cyngn, Inc. (CYN).
  • 4 reported transactions and 2 derivative rows are listed below.
  • Accepted by SEC: 22 Oct 2021, 16:33.

Change

  • Previous filing in this sequence was filed on 19 Oct 2021.
  • Current net transaction value: $0.

Research use

  • This tells you what this filing adds before you inspect full transaction and derivative tables.
  • You can trace every row back to the original SEC filing document.

Evidence

Filed on Form 4

Ownership activity is grounded in SEC Form 4 disclosures.

View source filing

Reported non-derivative transactions

Shares, units, or other non-derivative securities reported in this filing.

CYN transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+4,947,110
Change %
Price
Shares after
4,947,110
Date
22 Oct 2021
Ownership
By Andreessen Horowitz Fund III, L.P.
Footnotes
F1, F2
CYN transaction

Common Stock

Conversion of derivative security

Transaction value
Shares
+287,718
Change %
Price
Shares after
287,718
Date
22 Oct 2021
Ownership
By Andreessen Horowitz Fund III, L.P.
Footnotes
F1, F2

Reported derivative securities

Options, warrants, convertible securities, or similar derivative positions disclosed in the filing.

CYN transaction Derivative

Series B Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-4,947,110
Change %
-100%
Price
$0.000000*
Shares after
0
Date
22 Oct 2021
Ownership
By Andreessen Horowitz Fund III, L.P.
Underlying class
Common Stock
Underlying amount
4,947,110
Exercise price
Footnotes
F1, F2
CYN transaction Derivative

Series C Preferred Stock

Conversion of derivative security

Transaction value
$0
Shares
-287,718
Change %
-100%
Price
$0.000000*
Shares after
0
Date
22 Oct 2021
Ownership
By Andreessen Horowitz Fund III, L.P.
Underlying class
Common Stock
Underlying amount
287,718
Exercise price
Footnotes
F1, F2
* marks a reported price that did not pass the local price check.

Additional SEC filing notes

Filing notes and footnotes

Explanation of responses 2 footnotes

Footnote F1

These shares of Preferred Stock automatically converted into shares of the Issuer's Common Stock on a 1-for-1 basis, without payment or further consideration, immediately prior to the consummation of the Issuer's initial public offering.

Footnote F2

These securities are held by Andreessen Horowitz Fund III, L.P., for itself and as nominee for Andreessen Horowitz Fund III-A, L.P., Andreessen Horowitz Fund III-B, L.P., and Andreessen Horowitz Fund III-Q, L.P. (collectively, the "AH Fund III Entities"). AH Equity Partners III, L.L.C. ("AH EP III") is the general partner of the AH Fund III Entities and has sole voting and dispositive power with regard to the securities held by the AH Fund III Entities. Marc Andreessen and Benjamin Horowitz are the managing members of AH EP III and share voting and dispositive power with respect to the shares held by the AH Fund III Entities. Each of the Reporting Persons disclaims the existence of a "group" and disclaims beneficial ownership of the securities held by the AH Fund III Entities and this report shall not be deemed an admission that any such person is the beneficial owner of such securities, except to the extent of such person's pecuniary interest therein, if any.

SEC remarks

Scott Kupor has signed this Form 3 on behalf of Marc Andreessen and Benjamin Horowitz pursuant to a Power of Attorney already on file with the U.S. Securities and Exchange Commission.

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