0001571049-16-010849.txt : 20160120
0001571049-16-010849.hdr.sgml : 20160120
20160120162345
ACCESSION NUMBER: 0001571049-16-010849
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20160115
FILED AS OF DATE: 20160120
DATE AS OF CHANGE: 20160120
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: Chang William H
CENTRAL INDEX KEY: 0001594408
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-36305
FILM NUMBER: 161351247
MAIL ADDRESS:
STREET 1: C/O SEMLER SCIENTIFIC, INC.
STREET 2: 2330 NW EVERETT ST.
CITY: PORTLAND
STATE: OR
ZIP: 97210
4
1
t1600179-chang.xml
OWNERSHIP DOCUMENT
X0306
4
2016-01-15
0
0001554859
Semler Scientific, Inc.
SMLR
0001594408
Chang William H
C/O SEMLER SCIENTIFIC, INC.
2330 NW EVERETT ST.
PORTLAND
OR
97210
0
0
1
0
Common Stock Warrant (right to buy)
1.75
2016-01-15
4
A
0
114268
0.00
A
2018-01-15
Common Stock
114268
114268
I
By Chang Family Trust
The warrants are currently exercisable, although the Reporting Person may not exercise the warrants absent receipt of stockholder approval if upon exercise, the Reporting Person would beneficially own in excess of 19.99% of the Issuer's common stock.
/s/ Daniel E. Conger, attorney-in-fact
2016-01-20