0001144204-17-034214.txt : 20170627
0001144204-17-034214.hdr.sgml : 20170627
20170627060412
ACCESSION NUMBER: 0001144204-17-034214
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170623
FILED AS OF DATE: 20170627
DATE AS OF CHANGE: 20170627
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: Ruiz Roberto
CENTRAL INDEX KEY: 0001563443
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-35521
FILM NUMBER: 17931105
MAIL ADDRESS:
STREET 1: 12870 INTERURBAN AVENUE SOUTH
CITY: SEATTLE
STATE: WA
ZIP: 98168
4
1
v469735_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-06-23
0
0001434524
CLEARSIGN COMBUSTION CORP
CLIR
0001563443
Ruiz Roberto
12870 INTERURBAN AVENUE SOUTH
SEATTLE
WA
98168
0
1
0
0
Chief Operating Officer
Option to Purchase Common Stock
3.80
2017-06-23
4
A
0
10000
0.00
A
2027-04-01
Common Stock
10000
121500
D
The right to purchase the option shares vests at the rate of 6.25% commencing on June 30, 2017 and continuing thereafter on the last day of each quarter until the right to purchase all of the option shares has vested.
/s/ Roberto Ruiz
2017-06-26