0001104659-21-007286.txt : 20210125 0001104659-21-007286.hdr.sgml : 20210125 20210125175152 ACCESSION NUMBER: 0001104659-21-007286 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210122 FILED AS OF DATE: 20210125 DATE AS OF CHANGE: 20210125 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pate Bruce Alan CENTRAL INDEX KEY: 0001765385 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 21551010 MAIL ADDRESS: STREET 1: 23235 WALLING RD. CITY: GEYSERVILLE STATE: CA ZIP: 95441 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ClearSign Technologies Corp CENTRAL INDEX KEY: 0001434524 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 000000000 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 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 FORMER COMPANY: FORMER CONFORMED NAME: CLEARSIGN COMBUSTION CORP DATE OF NAME CHANGE: 20080507 4 1 tm214006d1_4.xml FORM 4 X0306 4 2021-01-22 0 0001434524 ClearSign Technologies Corp CLIR 0001765385 Pate Bruce Alan 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 1 0 0 0 Options to Purchase Common Stock 3.97 2021-01-22 4 A 0 19750 0.00 A 2021-04-01 2031-01-21 Common Stock 19750 19750 D Options to Purchase Common Stock 2.38 2020-11-19 2030-11-18 Common Stock 19750 19750 D Options to Purchase Common Stock 2.30 2020-08-18 2030-08-17 Common Stock 19750 19750 D Options to Purchase Common Stock 0.49 2020-05-19 2030-05-19 Common Stock 19750 19750 D Option to Purchase Common Stock 0.72 2020-04-01 2030-04-01 Common Stock 19750 19750 D Option to Purchase Common Stock 1.00 2029-04-01 Common Stock 70500 70500 D On January 22, 2021, the Issuer's board of directors approved compensation to be paid to the Issuer's non-executive directors for services provided to the Issuer during the period from January 1, 2021 to March 31, 2021. The reporting person is a non-executive director. As compensation for their services, each non-executive director was awarded options for shares of common stock having an exercise price of $3.97. The options fully vest on April 1, 2021, subject to the reporting person's continued service as a non-executive director to the Issuer. The total numbers of option shares awarded was based on the services provided by the director. These services include Board participation, committee participation, committee chair responsibilities and lead director responsibilities, if any. The award was recommended to the Issuer's board of directors by its compensation committee and issued from the Issuer's 2011 Equity Incentive Plan. The right to exercise the option and purchase the option shares vested in equal increments as follows: the right to purchase 17,625 shares vested on May 9, 2019 and the right to purchase the remaining 52,875 shares vested in equal increments on the last day of each calendar quarter during 2019. /s/ Bruce A. Pate 2021-01-25