0001104659-23-106901.txt : 20231004
0001104659-23-106901.hdr.sgml : 20231004
20231004174701
ACCESSION NUMBER: 0001104659-23-106901
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20231002
FILED AS OF DATE: 20231004
DATE AS OF CHANGE: 20231004
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: de Lacy Catharine
CENTRAL INDEX KEY: 0001966673
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 231309094
MAIL ADDRESS:
STREET 1: 6 VILLAGE NORTH DR
STREET 2: #107
CITY: HILTON HEAD
STATE: SC
ZIP: 29926
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: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 8023 E. 63RD PLACE, SUITE 101
CITY: TULSA
STATE: OK
ZIP: 74133
BUSINESS PHONE: (918) 236-6461
MAIL ADDRESS:
STREET 1: 8023 E. 63RD PLACE, SUITE 101
CITY: TULSA
STATE: OK
ZIP: 74133
FORMER COMPANY:
FORMER CONFORMED NAME: CLEARSIGN COMBUSTION CORP
DATE OF NAME CHANGE: 20080507
4
1
tm2327697-4_4seq1.xml
OWNERSHIP DOCUMENT
X0508
4
2023-10-02
0
0001434524
ClearSign Technologies Corp
CLIR
0001966673
de Lacy Catharine
8023 E. 63RD PLACE, SUITE 101
TULSA
OK
74133
1
0
0
0
0
Restricted Stock Units
2023-10-02
4
A
0
18333
0.00
A
Common Stock
18333
64861
D
As compensation for services as a non-executive director during the quarter ending December 31, 2023, the reporting person was granted restricted stock units ("RSUs") under the ClearSign Technologies Corporation 2021 Equity Incentive Plan and each RSU represents a right to receive one share of common stock or the cash equivalent thereof.
The RSUs will vest upon the first to occur of: (1) a Change in Control (as defined in the applicable RSU award agreement), (2) the reporting person's Disability (as defined in the applicable RSU award agreement); (3) the reporting person's death; or (4) the reporting person's separation from service.
/s/ Catharine de Lacy
2023-10-04