0001104659-22-001688.txt : 20220105
0001104659-22-001688.hdr.sgml : 20220105
20220105214150
ACCESSION NUMBER: 0001104659-22-001688
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20220103
FILED AS OF DATE: 20220105
DATE AS OF CHANGE: 20220105
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Meline Susanne
CENTRAL INDEX KEY: 0001731684
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 22513531
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 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: 8023 E. 63RD PLACE, SUITE 101
CITY: TULSA
STATE: OK
ZIP: 74133
BUSINESS PHONE: (918) 236-7770
MAIL ADDRESS:
STREET 1: 8023 E. 63RD PLACE, SUITE 101
CITY: TULSA
STATE: OK
ZIP: 74133
FORMER COMPANY:
FORMER CONFORMED NAME: CLEARSIGN COMBUSTION CORP
DATE OF NAME CHANGE: 20080507
4
1
tm221817d4_4.xml
OWNERSHIP DOCUMENT
X0306
4
2022-01-03
0
0001434524
ClearSign Technologies Corp
CLIR
0001731684
Meline Susanne
8023 E. 63RD PLACE, SUITE 101
TULSA
OK
74133
1
0
0
0
Restricted Stock Units
2022-01-03
4
A
0
16145
0.00
A
Common Stock
16145
16145
D
Restricted Stock Units
Common Stock
14531
14531
D
Restricted Stock Units
Common Stock
8017
8017
D
Restricted Stock Units
Common Stock
8017
8017
D
Option to Purchase Common Stock
3.97
2021-04-01
2031-01-21
Common Stock
22750
22750
D
Option to Purchase Common Stock
2.38
2020-11-19
2030-11-18
Common Stock
22750
22750
D
Option to Purchase Common Stock
2.30
2020-08-18
2030-05-17
Common Stock
22750
22750
D
Option to Purchase Common Stock
0.54
2020-05-18
2030-05-18
Common Stock
22750
22750
D
Option to Purchase Common Stock
0.72
2020-04-01
2030-04-01
Common Stock
22750
22750
D
Option to Purchase Common Stock
1.00
2029-04-01
Common Stock
91000
91000
D
As compensation for services as a non-executive director during the quarter ending March 31, 2022, the reporting person was granted restricted stock units ("RSUs") under the ClearSign Technologies Corporation 2021 Equity Incentive Plan and each RSU represents a right to receive one share of common stock or the cash equivalent thereof.
The RSUs will vest upon the first to occur of: (1) a Change in Control (as defined in the applicable RSU award agreement), (2) the reporting person's Disability (as defined in the applicable RSU award agreement); (3) the reporting peron's death; or (4) the reporting person's separation from service.
As compensation for services as a non-executive director during the quarter ended December 31, 2021, the reporting person was granted RSUs under the ClearSign Technologies Corporation 2021 Equity Incentive Plan and each RSU represents a right to receive one share of common stock or the cash equivalent thereof.
As compensation for services as a non-executive director during the quarter ended September 30, 2021, the reporting person was granted RSUs under the ClearSign Technologies Corporation 2021 Equity Incentive Plan and each RSU represents a right to receive one share of common stock or the cash equivalent thereof.
As compensation for services as a non-executive director during the quarter ended June 30, 2021, the reporting person was granted RSUs under the ClearSign Technologies Corporation 2021 Equity Incentive Plan and each RSU represents a right to receive one share of common stock or the cash equivalent thereof.
The right to exercise the option and purchase the option shares vested 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 vested in equal increments on the last day of each calendar quarter during 2019.
/s/ Susanne Meline
2022-01-05