0001144204-17-032786.txt : 20170615
0001144204-17-032786.hdr.sgml : 20170615
20170615184525
ACCESSION NUMBER: 0001144204-17-032786
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20170614
FILED AS OF DATE: 20170615
DATE AS OF CHANGE: 20170615
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: 2330 N.W. EVERETT STREET
CITY: PORTLAND
STATE: OR
ZIP: 97210
BUSINESS PHONE: 408-627-4557
MAIL ADDRESS:
STREET 1: 2330 N.W. EVERETT STREET
CITY: PORTLAND
STATE: OR
ZIP: 97210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Semler Shirley L.
CENTRAL INDEX KEY: 0001594358
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 17914525
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 2330 NW EVERETT ST.
CITY: PORTLAND
STATE: OR
ZIP: 97210
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Semler Herbert J
CENTRAL INDEX KEY: 0001594356
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 17914526
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 2330 NW EVERETT ST.
CITY: PORTLAND
STATE: OR
ZIP: 97210
4
1
v469096_form4.xml
FORM 4
X0306
4
2017-06-14
0
0001554859
Semler Scientific, Inc.
SMLR
0001594356
Semler Herbert J
C/O SEMLER SCIENTIFIC, INC.
2330 NW EVERETT ST.
PORTLAND
OR
97210
1
0
1
0
0001594358
Semler Shirley L.
C/O SEMLER SCIENTIFIC, INC.
2330 NW EVERETT ST.
PORTLAND
OR
97210
0
0
1
0
Common Stock
2017-06-14
4
M
0
150000
0.52
A
180000
D
Common Stock
378064
I
See footnote
Stock Option (right to buy)
0.52
2017-06-14
4
M
0
150000
0
A
2008-01-01
2018-01-01
Common Stock
150000
0
D
This option was held directly by Dr. Herbert J. Semler.
These securities are held in family trusts and may be deemed to be beneficially owned by the reporting persons as beneficiaries and Co-Trustees of such trusts.
/s/ Daniel E. Conger, attorney-in-fact
2017-06-15
/s/ Daniel E. Conger, attorney-in-fact
2017-06-15