0001144204-17-009076.txt : 20170214 0001144204-17-009076.hdr.sgml : 20170214 20170214175225 ACCESSION NUMBER: 0001144204-17-009076 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170210 FILED AS OF DATE: 20170214 DATE AS OF CHANGE: 20170214 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: BELL LON E CENTRAL INDEX KEY: 0000941593 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-35521 FILM NUMBER: 17611474 MAIL ADDRESS: STREET 1: C/O AMERIGON INC STREET 2: 5462 IRWINDALE AVENUE CITY: IRWINDALE STATE: CA ZIP: 91706 4 1 v459429_4.xml OWNERSHIP DOCUMENT X0306 4 2017-02-10 0 0001434524 CLEARSIGN COMBUSTION CORP CLIR 0000941593 BELL LON E 12870 INTERURBAN AVENUE SOUTH SEATTLE WA 98168 1 0 0 0 Common Stock/CLIR 2017-02-10 4 A 0 27778 A 243472 D On February 10, 2017, the Issuer's Compensation Committee approved annual compensation for the Issuer's independent directors. The reporting person is an independent director. As full compensation for services provided to the Issuer during 2017, each independent director was granted 27,778 shares of common stock, having a per share value of $3.60, the closing price of the Issuer's common stock on the date of grant. The Company has the right torepurchase the shares at a price of $0.0001 per share upon the termination of the reporting person's services as a director or other circumstances designated in the award agreement. The repurchase right expires on February 10, 2018. The shares will be issued from the Issuer's 2011 Equity Compensation Plan. /s/ Lon E. Bell 2017-02-14