SEC Form 4 · accession 0001144204-17-004022
ClearSign Technologies Corp · CLIR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lon E Bell
Director
Period of report
Jan 25, 2017
Accepted (ET)
Jan 26, 2017 · 4:26 pm EST
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/CLIRF1 | Jan 25, 2017 | X | 35,336 | $4.00 | A | 215,694 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Subscription Rights (Right to Purchase)F1 | $4.00 | Dec 27, 2016 | X | 35,336 | D | Dec 27, 2016 | Jan 13, 2017 | See Footnote | 35,336 | 0 | D |
| Warrant to Purchase Common StockF1,F2 | $4.00 | Jan 25, 2017 | X | 35,336 | A | Jan 25, 2017 | Jan 25, 2019 | Common Stock | 35,336 | 35,336 | D |
Explanation of responses
- F1The common stock and the warrants reported on this Form 4 were acquired pursuant to the exercise of subscription rights previously distributed by the Issuer to all holders of the Issuer's common stock. Each holder received 0.2 subscription rights per share of stock owned, and each right allowed the recipient to purchase one unit, consisting of one share of common stock and one warrant to purchase one share of common stock. The subscription price per unit was $4.00.
- F2Each warrant entitles the holder to purchase one share of the Company's common stock at an exercise price of $4.00 from the date of issuance through January 25, 2019.