0001144204-17-044836.txt : 20170823 0001144204-17-044836.hdr.sgml : 20170823 20170823194314 ACCESSION NUMBER: 0001144204-17-044836 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170822 FILED AS OF DATE: 20170823 DATE AS OF CHANGE: 20170823 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Kendrick Donald W CENTRAL INDEX KEY: 0001673849 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 171048012 MAIL ADDRESS: STREET 1: 12870 INTERURBAN AVENUE SOUTH CITY: SEATTLE STATE: WA ZIP: 98168 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CLEARSIGN COMBUSTION CORP CENTRAL INDEX KEY: 0001434524 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 000000000 STATE OF INCORPORATION: WA BUSINESS ADDRESS: STREET 1: 12870 INTERURBAN AVENUE SOUTH CITY: SEATTLE STATE: WA ZIP: 98168 BUSINESS PHONE: (206) 673-4848 MAIL ADDRESS: STREET 1: 12870 INTERURBAN AVENUE SOUTH CITY: SEATTLE STATE: WA ZIP: 98168 4 1 v473948_4.xml OWNERSHIP DOCUMENT X0306 4 2017-08-22 0 0001434524 CLEARSIGN COMBUSTION CORP CLIR 0001673849 Kendrick Donald W 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 0 1 0 0 Chief Technology Officer Common Stock/CLIR 29233 D Common Stock/CLIR 2017-08-22 4 P 0 5000 2.8907 A 20600 I By IRA /s/ Donald W. Kendrick 2017-08-23