0001571049-15-007798.txt : 20150921 0001571049-15-007798.hdr.sgml : 20150921 20150921162114 ACCESSION NUMBER: 0001571049-15-007798 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20150918 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: Garfield Greg Shaw CENTRAL INDEX KEY: 0001594406 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 151117597 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2330 NW EVERETT ST. CITY: PORTLAND STATE: OR ZIP: 97210 4 1 t1502168_x5-garfield.xml OWNERSHIP DOCUMENT X0306 4 2015-09-18 0 0001554859 Semler Scientific, Inc. SMLR 0001594406 Garfield Greg Shaw C/O SEMLER SCIENTIFIC, INC. 2330 NW EVERETT ST. PORTLAND OR 97210 1 0 0 0 Common Stock Warrant (right to buy) 4.5 2015-09-18 4 D 0 12000 0 D 2016-07-31 Common Stock 12000 0 I By Greg and Dori Garfield Living Revocable Trust Common Stock Warrant (right to buy) 4.5 2015-09-18 4 A 0 12000 0 A 2023-07-31 Common Stock 12000 12000 I By Greg and Dori Garfield Living Revocable Trust The two reported transactions involved an amendment of an outstanding warrant, resulting in the deemed cancellation of the "old" warrant and the grant of a replacement warrant. The warrant was originally issued on July 1, 2013. /s/ Daniel E. Conger, attorney-in-fact 2015-09-21