0001104659-19-061706.txt : 20191108 0001104659-19-061706.hdr.sgml : 20191108 20191108161910 ACCESSION NUMBER: 0001104659-19-061706 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20191106 FILED AS OF DATE: 20191108 DATE AS OF CHANGE: 20191108 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Murphy-Chutorian Douglas CENTRAL INDEX KEY: 0001594342 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 191204306 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Semler Scientific, Inc. CENTRAL INDEX KEY: 0001554859 STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845] IRS NUMBER: 261367393 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 BUSINESS PHONE: 408-627-4557 MAIL ADDRESS: STREET 1: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 4 1 tm1921322d2_4.xml OWNERSHIP DOCUMENT X0306 4 2019-11-06 0 0001554859 Semler Scientific, Inc. SMLR 0001594342 Murphy-Chutorian Douglas C/O SEMLER SCIENTIFIC, INC. 911 BERN COURT SAN JOSE CA 95112 1 1 1 0 Chief Executive Officer Common Stock Warrant (right to buy) 4.5 2019-11-06 4 D 0 16390 41.4 D 2012-06-07 2023-07-31 Common Stock 16390 0 I By Trust Common Stock Warrant (right to buy) 4.5 2019-11-06 4 D 0 22517 41.4 D 2012-06-07 2023-07-31 Common Stock 22517 0 I By Trust Common Stock Warrant (right to buy) 2 2019-11-06 4 D 0 25000 43.9 D 2012-06-07 2023-07-31 Common Stock 25000 0 I By Trust Common Stock Warrant (right to buy) 4.5 2019-11-06 4 D 0 29890 41.4 D 2012-08-31 2023-07-31 Common Stock 29890 0 I By Trust The Reporting Person sold these warrants to the Issuer. The net purchase price per warrant reflects the difference between the aggregate exercise price of the warrant and the aggregate fair market value of the shares underlying the warrant, based on the last trade price of the Company's common stock on November 6, 2019. The net sale dollar amount was $3,945,695.80 in total received from the Issuer. The warrants were held by the Murphy-Chutorian Family Trust U/D/T dated January 13, 1997, of which the Reporting Person is co-Trustee with his spouse. /s/ Douglas Murphy-Chutorian, M.D. 2019-11-08