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