0001104659-21-075888.txt : 20210602 0001104659-21-075888.hdr.sgml : 20210602 20210602183835 ACCESSION NUMBER: 0001104659-21-075888 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210528 FILED AS OF DATE: 20210602 DATE AS OF CHANGE: 20210602 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: 21990681 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: 21990680 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 2020 Delaware LP CENTRAL INDEX KEY: 0001855256 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 21990677 BUSINESS ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2340-2348 WALSH AVENUE, SUITE 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 BUSINESS PHONE: (677) 774-4211 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2340-2348 WALSH AVENUE, SUITE 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 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: 21990679 MAIL ADDRESS: STREET 1: 1301 SHOREWAY RD., SUITE 150 CITY: BELMONT STATE: CA ZIP: 94002 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Chang 2020 GP LLC CENTRAL INDEX KEY: 0001847364 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 21990678 BUSINESS ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2340-2348 WALSH AVENUE, STE. 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 BUSINESS PHONE: (877) 774-4211 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2340-2348 WALSH AVENUE, STE. 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 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: 2340-2348 WALSH AVENUE, SUITE 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 BUSINESS PHONE: 408-627-4557 MAIL ADDRESS: STREET 1: 2340-2348 WALSH AVENUE, SUITE 2344 CITY: SANTA CLARA STATE: CA ZIP: 95051 4 1 tm2118323d1_4.xml OWNERSHIP DOCUMENT X0306 4 2021-05-28 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. 2340-2348 WALSH AVENUE, SUITE 2344 SANTA CLARA CA 95051 0 0 1 0 0001793712 Chang Diana Shon C/O SEMLER SCIENTIFIC, INC. 2340-2348 WALSH AVENUE, SUITE 2344 SANTA CLARA CA 95051 0 0 1 0 0001847364 Chang 2020 GP LLC C/O SEMLER SCIENTIFIC, INC. 2340-2348 WALSH AVENUE, SUITE 2344 SANTA CLARA CA 95051 0 0 1 0 0001855256 Chang 2020 Delaware LP C/O SEMLER SCIENTIFIC, INC. 2340-2348 WALSH AVENUE, SUITE 2344 SANTA CLARA CA 95051 0 0 1 0 Common Stock 2021-04-19 4 G 0 2416 0 D 0 I See Footnote Common Stock 2021-04-19 4 G 0 2416 0 A 2416 I See Footnote Common Stock 2021-05-28 4 S 0 1000 110 D 416537 I See Footnote Common Stock 2021-06-01 4 S 0 38 110.0947 D 416499 I See Footnote Common Stock 2021-06-01 4 S 0 25 111.50 D 416474 I See Footnote Common Stock 350376 D Common Stock 350376 D Shares are held by Chang 2020 GP LLC, for which Mr. and Mrs. Chang are the sole managers and share voting and investment control. Shares are held by Chang 2020 Delaware LP, for which Mr. and Mrs. Chang are the sole general partners and share voting and investment control. Shares are held directly by William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006. The price reported in Column 4 is a weighted average price. These shares were sold in multiple transactions at prices ranging from $110.00 to $110.10, inclusive. The reporting person undertakes to provide to the Issuer, any security holder of the Issuer, or the staff of the Securities and Exchange Commission, upon request, full information regarding the number of shares sold at each separate price within the ranges set forth in footnote 4 to this Form 4. 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 2021-06-02 /s/ Diana Shon Chang 2021-06-02 /s/ William H.C. Chang, Manager 2021-06-02 /s/ William H.C. Chang, General Partner 2021-06-02 /s/ William H.C. Chang, Co-Trustee 2021-06-02