0001144204-16-100171.txt : 20160510
0001144204-16-100171.hdr.sgml : 20160510
20160510091523
ACCESSION NUMBER: 0001144204-16-100171
CONFORMED SUBMISSION TYPE: 3
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160505
FILED AS OF DATE: 20160510
DATE AS OF CHANGE: 20160510
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
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
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Kendrick Donald W
CENTRAL INDEX KEY: 0001673849
FILING VALUES:
FORM TYPE: 3
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 161633906
MAIL ADDRESS:
STREET 1: 12870 INTERURBAN AVENUE SOUTH
CITY: SEATTLE
STATE: WA
ZIP: 98168
3
1
v439315_3.xml
OWNERSHIP DOCUMENT
X0206
3
2016-05-05
0
0001434524
CLEARSIGN COMBUSTION CORP
CLIR
0001673849
Kendrick Donald W
12870 INTERURBAN AVENUE SOUTH
SEATTLE
WA
98168
0
1
0
0
Senior VP of Technology
Common Stock
7000
D
Common Stock
13000
I
By IRA
Option to Purchase Common Stock
5.07
2025-03-31
Common Stock
25000
D
Option to Purchase Common Stock
4.21
2026-03-31
Common Stock
25000
D
The right to purchase the option shares vests 40% on April 1, 2016 and then 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 vests 6.25% 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.
/s/ Donald W. Kendrick, Ph.D.
2016-05-10