0001209191-21-069363.txt : 20211214 0001209191-21-069363.hdr.sgml : 20211214 20211214083944 ACCESSION NUMBER: 0001209191-21-069363 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20211210 FILED AS OF DATE: 20211214 DATE AS OF CHANGE: 20211214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Lewis Daniel Lee CENTRAL INDEX KEY: 0001718088 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-32929 FILM NUMBER: 211489762 MAIL ADDRESS: STREET 1: 166 W PEARL STREET CITY: COLDWATER STATE: MI ZIP: 49036 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 2021-12-10 0 0000890394 MoSys, Inc. MOSY 0001718088 Lewis Daniel Lee 2309 BERING DR SAN JOSE CA 95131 1 1 0 0 Chief Executive Officer Common Stock 2021-12-10 4 P 0 5000 3.94 A 37250 D Shares were purchased by the reporting person in a joint account with the reporting person's spouse. /s/ James Sullivan by power of attorney 2021-12-14