0001104659-19-058382.txt : 20191031
0001104659-19-058382.hdr.sgml : 20191031
20191031163131
ACCESSION NUMBER: 0001104659-19-058382
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190509
FILED AS OF DATE: 20191031
DATE AS OF CHANGE: 20191031
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Meline Susanne
CENTRAL INDEX KEY: 0001731684
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 191184018
MAIL ADDRESS:
STREET 1: P.O. BOX 515381
STREET 2: #86506
CITY: LOS ANGELES
STATE: CA
ZIP: 90051
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/A
1
tm1921550-5_4aseq1.xml
OWNERSHIP DOCUMENT
X0306
4/A
2019-05-09
2019-05-13
0
0001434524
CLEARSIGN COMBUSTION CORP
CLIR
0001731684
Meline Susanne
12870 INTERURBAN AVENUE SOUTH
SEATTLE
WA
98168
1
0
0
0
Option to Purchase Common Stock
1.00
2019-05-09
4
A
0
91000
0.00
A
2029-04-01
Common Stock
91000
91000
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 2019. The reporting person is an 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 $1.00. The total number of option shares awarded was based on the services provided by the director. These services include Board participation, committee participation, committee chair responsibilites and lead director responsibilities, if any. The shares of common stock are issued from the Company's 2011 Equity Incentive Plan. The right to purchase the option shares vests in equal increments as follows: the right to purchase 22,750 shares vested on May 9, 2019 and the right to purchase the remaining 68,250 shares will vest in equal increments on the last day of each calendar quarter.
The purpose of this amendment to the Form 4 filed by the reporting person on May 13, 2019 (the "Original Form 4") is to provide corrected information relating to the option grant which is the subject of the report. The Original Form 4, together with the Form 4 filed on July 3, 2019, reported only that portion of the option grant that vested on May 9,2019 and June 30, 2019. This amendment reports the entire grant.
/s/ Susanne Meline
2019-10-31