0001104659-20-007246.txt : 20200127
0001104659-20-007246.hdr.sgml : 20200127
20200127181906
ACCESSION NUMBER: 0001104659-20-007246
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20200123
FILED AS OF DATE: 20200127
DATE AS OF CHANGE: 20200127
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006
CENTRAL INDEX KEY: 0001742975
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 20550927
BUSINESS ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 911 BERN CT.
CITY: SAN JOSE
STATE: CA
ZIP: 95112
BUSINESS PHONE: (877) 774-4211
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 911 BERN CT.
CITY: SAN JOSE
STATE: CA
ZIP: 95112
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chang William H
CENTRAL INDEX KEY: 0001594408
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 20550928
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 911 BERN COURT, SUITE 110
CITY: SAN JOSE
STATE: CA
ZIP: 95112
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Chang Diana Shon
CENTRAL INDEX KEY: 0001793712
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 20550929
MAIL ADDRESS:
STREET 1: 1301 SHOREWAY RD., SUITE 150
CITY: BELMONT
STATE: CA
ZIP: 94002
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
tm205960d1_form4.xml
FORM 4
X0306
4
2020-01-23
0
0001554859
Semler Scientific, Inc.
SMLR
0001742975
William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006
C/O SEMLER SCIENTIFIC, INC.
911 BERN COURT, SUITE 110.
SAN JOSE
CA
95112
0
0
1
0
0001594408
Chang William H
C/O SEMLER SCIENTIFIC, INC.
911 BERN COURT, SUITE 110.
SAN JOSE
CA
95112
0
0
1
0
0001793712
Chang Diana Shon
C/O SEMLER SCIENTIFIC, INC.
911 BERN COURT, SUITE 110.
SAN JOSE
CA
95112
0
0
1
0
Common Stock
2020-01-23
4
S
0
1000
50.00
D
392323
D
Common Stock
450000
D
Common Stock
450000
D
Shares are held directly by William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006 (the "Trust").
Shares are held in six GRATs, for which Mr. Chang acts as sole Trustee and has voting and investment control.
Shares are held in six GRATs, for which Mrs. Chang acts as sole Trustee and has voting and investment control.
/s/ William H.C. Chang, Co-Trustee
2020-01-27
/s/ William H.C. Chang
2020-01-27
/s/ Diana Shon Chang
2020-01-27