0001144204-19-025698.txt : 20190513 0001144204-19-025698.hdr.sgml : 20190513 20190513184741 ACCESSION NUMBER: 0001144204-19-025698 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190509 FILED AS OF DATE: 20190513 DATE AS OF CHANGE: 20190513 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SIMMONS JAMES M CENTRAL INDEX KEY: 0001238466 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 19820017 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 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 4 1 tv521424_4.xml OWNERSHIP DOCUMENT X0306 4 2019-05-09 0 0001434524 CLEARSIGN COMBUSTION CORP CLIR 0001238466 SIMMONS JAMES M 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 1 0 0 0 Option to Purchase Common Stock 1.00 2019-05-09 4 A 0 16250 0.00 A 2029-04-01 Common Stock 16250 16250 D On May 9, 2019, 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 first quarter of 2019. The reporting person is a non-executive director. The number of option shares awarded was based on the services provided by the director. These services include, depending on the individual, Board participation, committee participation, committee chair responsibilities and lead director responsibilities, if any. The shares of common stock are issued from the Company's 2011 Equity Incentive Plan. /s/ James M. Simmons 2019-05-13