0001571049-15-007796.txt : 20150921 0001571049-15-007796.hdr.sgml : 20150921 20150921161111 ACCESSION NUMBER: 0001571049-15-007796 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150911 FILED AS OF DATE: 20150921 DATE AS OF CHANGE: 20150921 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: 151117500 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: 151117501 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2330 NW EVERETT ST. CITY: PORTLAND STATE: OR ZIP: 97210 4 1 t1502168_x2-semler.xml OWNERSHIP DOCUMENT X0306 4 2015-09-11 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 2015-09-11 4 S 0 16494 2.46 D 508064 I See footnote 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. Shirley L. Semler is also a director of the Company. /s/ Daniel E. Conger, attorney-in-fact 2015-09-21 /s/ Daniel E. Conger, attorney-in-fact 2015-09-21