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