SEC Form 3 · accession 0001062993-18-003062

ClearSign Technologies Corp · CLIR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

10% Owner

Period of report

Jul 20, 2018

Accepted (ET)

Jul 30, 2018 · 4:43 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001434524

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1,F2	holding	—	—		—	5,213,543	D

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Contractual Right to Purchase Common Stock^F1,F2	$4.00	holding	—	—	—	Jul 20, 2018	Feb 1, 2019	Contractual Right to Purchase Common Stock	478,854	—	I

F1clirSPV LLC ("clirSPV") is the record holder of the securities reported herein. GPclirSPV LLC ("GPclirSPV") is the Manager of clirSPV. Princeton Opportunity Management LLC ("Princeton Opportunity Management") has an Investment Management Agreement for clirSPV.
F2Robert T. Hoffman is the Managing Member of GPclirSPV and Princeton Opportunity Management and shares the power to vote and dispose of the securities beneficially owned by clirSPV. As such, each of GPclirSPV, Princeton Opportunity Management and Robert T. Hoffman Sr. may be deemed to have or share beneficial ownership of the Common Stock or Contractual Rights to Purchase Common Stock held directly by clirSPV. Each such entity or individual other than clirSPV disclaims any such beneficial ownership except to the extent of their pecuniary interest therein.