ClearSign Technologies Corp — Director's Dealing 2012

Jun 26, 2012

SEC Form 4 — Statement of Changes in Beneficial Ownership

Issuer: CLEARSIGN COMBUSTION CORP (CLIR)
CIK: 0001434524
Period of Report: 2012-05-09

Reporting Person: MARLETT CHRISTOPHER A (Former 10% Owner)

Non-Derivative Transactions

Date	Security	Code	Shares	Price	A/D	Holdings After	Ownership
2012-05-09	Common Stock	J	342035	—	Disposed	3593	Indirect
2012-05-09	Common Stock	J	17664	—	Acquired	92237	Direct
2012-05-09	Common Stock	J	91253	—	Acquired	380460	Indirect

Footnotes

F1: The record holder of these securities is Integrated Surgical Systems, Inc. ("ISS"). The reporting person is a shareholder, the Chief Executive Officer and one of 4 directors of ISS. On April 24, 2012, the full board of directors of ISS declared a dividend to the shareholders of ISS, of an aggregate of 450,952 shares of common stock of the Issuer. The record date of the dividend was May 9, 2012.

F2: Represents dividend shares distributed to ISS shareholders other than the reporting person (see Note 1 above).

F3: The record holder of these securities is ISS. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be an admission of beneficial ownership of all of the reported securities for purposes of Section 16 or for any other purpose.

F4: Represents dividend shares distributed to the reporting person (see Note 1 above) and a change from indirect ownership to direct ownership.

F5: Represents 45,626 shares distributed to Christopher A. Marlett IRA and 45,627 shares distributed to Christopher A. Marlett Living Trust (see Note 1 above), and a change in the record holder of indirect ownership.

F6: Represents 45,626 shares held of record by Christopher A. Marlett IRA, 45,627 shares held of record by Christopher A. Marlett Living Trust and 289,207 held of record by MDB Capital Group LLC ("MDB"), of which the reporting person is the Chief Executive Officer. The reporting person disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein, and the inclusion of these securities in this report shall not be an admission of beneficial ownership of all of the reported securities for purposes of Section 16 or for any other purpose.