0001571049-15-005715.txt : 20150720 0001571049-15-005715.hdr.sgml : 20150720 20150720191834 ACCESSION NUMBER: 0001571049-15-005715 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150715 FILED AS OF DATE: 20150720 DATE AS OF CHANGE: 20150720 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: 15996682 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: 15996683 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2330 NW EVERETT ST. CITY: PORTLAND STATE: OR ZIP: 97210 4 1 t1501641-semler.xml OWNERSHIP DOCUMENT X0306 4 2015-07-15 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 1 0 1 0 Common Stock 2015-07-15 4 S 0 33333 3.00 D 524558 I By Herbert J. Semler and Shirley L. Semler, as Co- Trustees of the Semler Trust These securities are held by the Semler Trust and may be deemed to be beneficially owned by Herbert J. Semler and Shirley L. Semler as Co-Trustees of the Semler Trust. Shirley L. Semler is also a director of the Company. Prior to the sale reported herein by the reporting persons, the shares were transferred into the Herbert J Semler Trust as record stockholder. /s/ Dan Conger, attorney-in-fact for Herbert J. Semler 2015-07-20 /s/ Dan Conger, attorney-in-fact for Shirley L. Semler 2015-07-20