0001144204-18-012275.txt : 20180301
0001144204-18-012275.hdr.sgml : 20180301
20180301164003
ACCESSION NUMBER: 0001144204-18-012275
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171207
FILED AS OF DATE: 20180301
DATE AS OF CHANGE: 20180301
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: 18658066
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 2330 NW EVERETT ST.
CITY: PORTLAND
STATE: OR
ZIP: 97210
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
4
1
tv487445_4.xml
OWNERSHIP DOCUMENT
X0306
4
2017-12-07
0
0001554859
Semler Scientific, Inc.
SMLR
0001594408
Chang William H
C/O SEMLER SCIENTIFIC, INC.
911 BERN CT.
SAN JOSE
CA
95112
0
0
1
0
Common Stock
2017-12-07
4
X
0
114286
1.75
A
1079592
I
By Chang Family Trust
Common Stock
2017-12-07
4
X
0
114286
1.75
A
1193878
I
By Chang Family Trust
Common Stock Warrant (right to buy)
1.75
2017-12-07
4
X
0
114286
0
D
2016-01-15
2018-01-15
Common Stock
114286
0
I
By Chang Family Trust
Common Stock Warrant (right to buy)
1.75
2017-12-07
4
X
0
114286
0
D
2016-01-21
2018-01-21
Common Stock
114286
0
I
By Chang Family Trust
/s/ Daniel E. Conger, attorney-in-fact
2018-03-01