0001571049-17-004462.txt : 20170504 0001571049-17-004462.hdr.sgml : 20170504 20170504161820 ACCESSION NUMBER: 0001571049-17-004462 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170502 FILED AS OF DATE: 20170504 DATE AS OF CHANGE: 20170504 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: 17814189 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 2330 NW EVERETT ST. CITY: PORTLAND STATE: OR ZIP: 97210 4 1 t1701344_x1-chang.xml OWNERSHIP DOCUMENT X0306 4 2017-05-02 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) 2.60 2017-05-02 4 P 0 134616 0.00 A 2017-05-02 2022-01-21 Common Stock 134616 134616 I By Chang Family Trust /s/ Daniel E. Conger, attorney-in-fact 2017-05-04