0001144204-19-005906.txt : 20190208
0001144204-19-005906.hdr.sgml : 20190208
20190208173041
ACCESSION NUMBER: 0001144204-19-005906
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20190206
FILED AS OF DATE: 20190208
DATE AS OF CHANGE: 20190208
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: 19581157
MAIL ADDRESS:
STREET 1: 12870 INTERURBAN AVENUE SOUTH
CITY: SEATTLE
STATE: WA
ZIP: 98168
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
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
4
1
tv512875_4.xml
OWNERSHIP DOCUMENT
X0306
4
2019-02-06
0
0001434524
CLEARSIGN COMBUSTION 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
1.21
2019-02-06
4
A
0
60000
0.00
A
2029-01-01
Common Stock
60000
165000
D
Option to Purchase Common Stock
1.21
2019-02-06
4
A
0
50000
0.00
A
2029-01-01
Common Stock
50000
215000
D
Option to Purchase Common Stock
2.25
2019-02-06
4
A
0
50000
0.00
A
2029-01-01
Common Stock
50000
265000
D
The right to purchase the option shares vested on the date of grant.
The right to purchase one-third of the shares subject to the options vested as of January 1, 2019. The right to purchase the remainder of the shares will vest as follows: one-third on January 1, 2020 and one third on January 1, 2021.
/s/ Donald Kendrick
2019-02-08