0001571049-16-010485.txt : 20160104 0001571049-16-010485.hdr.sgml : 20160104 20160104203418 ACCESSION NUMBER: 0001571049-16-010485 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20151231 FILED AS OF DATE: 20160104 DATE AS OF CHANGE: 20160104 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: Pan Wayne T CENTRAL INDEX KEY: 0001608075 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 161319962 MAIL ADDRESS: STREET 1: 2330 NW EVERETT STREET CITY: PORTLAND STATE: OR ZIP: 97210 4 1 t1600012_x5-f4.xml OWNERSHIP DOCUMENT X0306 4 2015-12-31 0 0001554859 Semler Scientific, Inc. SMLR 0001608075 Pan Wayne T C/O SEMLER SCIENTIFIC, INC. 2330 NW EVERETT STREET PORTLAND OR 97210 1 0 0 0 Stock Option (right to buy) 2.56 2015-12-31 4 A 0 6583 0 A 2025-12-30 Common Stock 6583 6583 D This fully vested option was granted under the issuer's 2014 Stock Incentive Plan. /s/ Dan Conger, attorney-in-fact 2016-01-04