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