0001104659-24-027573.txt : 20240226 0001104659-24-027573.hdr.sgml : 20240226 20240226170108 ACCESSION NUMBER: 0001104659-24-027573 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20240222 FILED AS OF DATE: 20240226 DATE AS OF CHANGE: 20240226 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Deller Colin James CENTRAL INDEX KEY: 0001766480 ORGANIZATION NAME: FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 24679962 MAIL ADDRESS: STREET 1: C/O CLEARSIGN COMBUSTION CORP. STREET 2: 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] ORGANIZATION NAME: 08 Industrial Applications and Services IRS NUMBER: 000000000 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8023 E. 63RD PLACE, SUITE 101 CITY: TULSA STATE: OK ZIP: 74133 BUSINESS PHONE: (918) 236-6461 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 tm247292-1_4seq1.xml OWNERSHIP DOCUMENT X0508 4 2024-02-22 0 0001434524 ClearSign Technologies Corp CLIR 0001766480 Deller Colin James 8023 E. 63RD PLACE, SUITE 101 TULSA OK 74133 0 1 0 0 Chief Executive Officer 0 Common Stock 2024-02-22 4 A 0 131121 0 A 186408 D Common Stock 2024-02-22 4 F 0 65102 1.06 D 121306 D Represents a one-time bonus grant to reporting person for services as an executive officer for the year ended December 31, 2023. The number of shares awarded is based on the closing price of the Company's common stock on February 22, 2024 of $1.06. Represents the payment of the reporting person's tax liability by withholding shares incident to the receipt of the Company's common stock issued on February 22, 2024 based on the closing price of the Company's common stock on February 22, 2024 of $1.06. /s/ Colin J. Deller 2024-02-26