Sec Form 4 Filing - Fike Brian Grant @ ClearSign Technologies Corp - 2020-01-09

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
Fike Brian Grant
2. Issuer Name and Ticker or Trading Symbol
ClearSign Technologies Corp [ CLIR]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
X __ Officer (give title below) _____ Other (specify below)
Chief Financial Officer
(Last) (First) (Middle)
12870 INTERURBAN AVENUE SOUTH
3. Date of Earliest Transaction (MM/DD/YY)
01/09/2020
(Street)
SEATTLE, WA98168
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option to Purchase Common Stock $ 0.89 01/09/2020 A 40,000 01/09/2020( 1 ) 01/09/2030 Common Stock 40,000 $ 0 40,000 D
Option to Purchase Common Stock $ 1.21 ( 2 ) 12/31/2028 Common Stock 50,000 50,000 D
Option to Purchase Common Stock $ 1.21 ( 3 ) 12/31/2028 Common Stock 50,000 50,000 D
Option to Purchase Common Stock $ 2.25 ( 3 ) 12/31/2028 Common Stock 50,000 50,000 D
Option to Purchase Common Stock $ 1.9 ( 4 ) 03/31/2028 Common Stock 25,000 25,000 D
Option to Purchase Common Stock $ 3.8 ( 5 ) 03/31/2027 Common Stock 10,000 10,000 D
Option to Purchase Common Stock $ 4.21 ( 6 ) 03/31/2026 Common Stock 5,000 5,000 D
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
Fike Brian Grant
12870 INTERURBAN AVENUE SOUTH
SEATTLE, WA98168
Chief Financial Officer
Signatures
/s/ Brian G. Fike 01/13/2020
Signature of Reporting Person Date
Explanation of Responses:
( 1 )The right to purchase the option shares vested on the date of award.
( 2 )The right to purchase the option shares vested on the date of award.
( 3 )The right to purchase one-third of the shares subject to the option vested as of January 1, 2019 and the right to purchase one-third of the shares subject to the option vested on January 1, 2020. The right to purchase the remaining shares will vest on January 1, 2021
( 4 )The right to purchase the option shares vested at the rate of 6.25% commencing on July 1, 2018 and continues thereafter on the last day of each quarter. until the right to purchase all of the option shares has vested.
( 5 )The right to purchase the option shares vested at the rate of 6.25% commencing on June 30, 2017 and continues thereafter on the last day of each quarter. until the right to purchase all of the option shares has vested.
( 6 )The right to purchase the option shares vested 40% on 4/1/2017 and continues at the rate of 5% per quarter thereafter on the last day of each quarter, until the right to purchase all of the option shares has vested.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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