0001104659-20-004074.txt : 20200114
0001104659-20-004074.hdr.sgml : 20200114
20200114202242
ACCESSION NUMBER: 0001104659-20-004074
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200109
FILED AS OF DATE: 20200114
DATE AS OF CHANGE: 20200114
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kendrick Donald W
CENTRAL INDEX KEY: 0001673849
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 20527168
MAIL ADDRESS:
STREET 1: 12870 INTERURBAN AVENUE SOUTH
CITY: SEATTLE
STATE: WA
ZIP: 98168
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: 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
FORMER COMPANY:
FORMER CONFORMED NAME: CLEARSIGN COMBUSTION CORP
DATE OF NAME CHANGE: 20080507
4
1
tm203461-1_4.xml
OWNERSHIP DOCUMENT
X0306
4
2020-01-09
0
0001434524
ClearSign Technologies Corp
CLIR
0001673849
Kendrick Donald W
12870 INTERURBAN AVENUE SOUTH
SEATTLE
WA
98168
0
1
0
0
Chief Technology Officer
Option to Purchase Common Stock
0.89
2020-01-09
4
A
0
40000
0.00
A
2030-01-09
Common Stock
40000
40000
D
Option to Purchase Common Stock
1.21
2029-01-01
Common Stock
60000
60000
D
Option to Purchase Common Stock
1.21
2029-01-01
Common Stock
50000
50000
D
Option to Purchase Common Stock
2.25
2029-01-01
Common Stock
50000
50000
D
Option to Purchase Common Stock
1.90
2028-04-01
Common Stock
30000
30000
D
Option to Purchase Common Stock
3.80
2027-04-01
Common Stock
25000
25000
D
Option to Purchase Common Stock
5.07
2025-03-31
Common Stock
25000
25000
D
Option to Purchase Common Stock
4.21
2026-03-31
Common Stock
25000
25000
D
The right to purchase 20,000 option shares vested on January 9, 2020, the grant date. The remaining 20,000 option shares will vest upon the completion of certain performance objectives.
The right to purchase these shares vested on February 9, 2019, the grant date.
The right to purchase the option shares vests as follows: one-third of the option shares vested on January 1, 2019, one-third of the option shares vested on January 1, 2020 and one third of the option shares will vest on January 1, 2021.
The right to purchase the option shares vests as follows: one-third of the option shares vested on January 1, 2019, one-third of the option shares vested on January 1, 2020 and one third of the option shares will vest on January 1, 2021.
The right to purchase the option shares vests at the rate of 6.25% commencing on July 1, 2018 and continues to vest thereafter on the first day of each quarter until the right to purchase all of the option shares has vested.
The right to purchase the option shares vested at the rate of 6.25% commencing on June 30, 2017 and continues to vest thereafter on the last day of each quarter until the right to purchase all of the option shares has vested.
The right to purchase the option shares vested 40% on April 1, 2016 and continues to vest thereafter at the rate of 5% commencing on July 1, 2016 and on each quarterly (3-month) anniversary until the right to purchase all of the shares has vested on July 1, 2020.
The right to purchase the option shares vested 6.25% on July 1, 2016 and continues to vest thereafter on each quarterly (3-month) anniversary until the right to purchase all of the shares has vested on July 1, 2020.
/s/ Donald Kenrick
2020-01-14