0001144204-17-034493.txt : 20170628 0001144204-17-034493.hdr.sgml : 20170628 20170628060250 ACCESSION NUMBER: 0001144204-17-034493 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170627 FILED AS OF DATE: 20170628 DATE AS OF CHANGE: 20170628 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: LEE ANDREW U CENTRAL INDEX KEY: 0001243871 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 17933660 4 1 v469849_4.xml OWNERSHIP DOCUMENT X0306 4 2017-06-27 0 0001434524 CLEARSIGN COMBUSTION CORP CLIR 0001243871 LEE ANDREW U 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 0 1 0 0 See Remarks Option to Purchase Common Stock 3.80 2017-06-27 4 A 0 12000 0.00 A 2027-04-01 Common Stock 12000 164855 D The reporting person was notified of the grant on June 27, 2017. The grant was made by the Compensation Committee by a Resolution of Unanimous Written Consent June 23, 2017. The right to purchase the option shares vests at the rate of 6.25% commencing on June 30, 2017 and continuing thereafter on the last day of each quarter until the right to purchase all of the option shares has vested. Senior Vice President of Business Development /s/ Andrew Lee 2017-06-27