0001144204-19-033826.txt : 20190703 0001144204-19-033826.hdr.sgml : 20190703 20190703172429 ACCESSION NUMBER: 0001144204-19-033826 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20190630 FILED AS OF DATE: 20190703 DATE AS OF CHANGE: 20190703 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Pate Bruce Alan CENTRAL INDEX KEY: 0001765385 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 19942641 MAIL ADDRESS: STREET 1: 23235 WALLING RD. CITY: GEYSERVILLE STATE: CA ZIP: 95441 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 tv524824_4.xml OWNERSHIP DOCUMENT X0306 4 2019-06-30 0 0001434524 CLEARSIGN COMBUSTION CORP CLIR 0001765385 Pate Bruce Alan 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 1 0 0 0 Option to Purchase Common Stock 1.00 2019-06-30 4 A 0 17625 0.00 A 2019-06-30 2029-04-01 Common Stock 17625 35250 D On May 9, 2019 the Issuer's board of directors approved compensation to be paid to the Issuer's non-executive directors for services provided to the Issuer during 2019. The reporting person is an non-executive director. As compensation for their services, each non-executive director was awarded options for shares of common stock having an exercise price of $1.00. The total number of option shares awarded was based on the services provided by the director. These services include Board participation, committee participation, committee chair responsibilites and lead director responsibilities, if any. The right to purchase the common stock is earned in quarterly increments. The option was issued from the Company's 2011 Equity Incentive Plan. /s/ Bruce A. Pate 2019-07-03