0001571049-18-000335.txt : 20180607 0001571049-18-000335.hdr.sgml : 20180607 20180607172853 ACCESSION NUMBER: 0001571049-18-000335 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20180420 FILED AS OF DATE: 20180607 DATE AS OF CHANGE: 20180607 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006 CENTRAL INDEX KEY: 0001742975 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36305 FILM NUMBER: 18887501 BUSINESS ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 911 BERN CT. CITY: SAN JOSE STATE: CA ZIP: 95112 BUSINESS PHONE: (877) 774-4211 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 911 BERN CT. CITY: SAN JOSE STATE: CA ZIP: 95112 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: 18887502 MAIL ADDRESS: STREET 1: C/O SEMLER SCIENTIFIC, INC. STREET 2: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 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: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 BUSINESS PHONE: 408-627-4557 MAIL ADDRESS: STREET 1: 911 BERN COURT, SUITE 110 CITY: SAN JOSE STATE: CA ZIP: 95112 4 1 tv496049_4.xml OWNERSHIP DOCUMENT X0306 4 2018-04-20 0 0001554859 Semler Scientific, Inc. SMLR 0001742975 William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006 C/O SEMLER SCIENTIFIC, INC. 911 BERN CT. SAN JOSE CA 95112 0 0 1 0 0001594408 Chang William H C/O SEMLER SCIENTIFIC, INC. 911 BERN COURT, SUITE 110 SAN JOSE CA 95112 0 0 1 0 Common Stock 2018-04-20 4 P 0 23975 8.34 A 1217853 D Common Stock 2018-04-20 4 P 0 23975 8.34 A 1241828 D Common Stock 2018-04-20 4 P 0 23975 8.34 A 1265803 D William H.C. & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006, by /s/ William H.C. Chang, Trustee 2018-06-07 /s/ William H. Chang 2018-06-07 EX-24 2 tv496049_ex24.htm POWER OF ATTORNEY

Exhibit 24

POWER OF ATTORNEY

Know all by these presents, that the undersigned hereby makes, constitutes and appoints each of Daniel Conger and Douglas Murphy-Chutorian, each acting individually, as the undersigned's true and lawful attorney-in-fact, with full power and authority as hereinafter described on behalf of and in the name, place and stead of the undersigned to:

(1)

execute for and on behalf of the undersigned, in the undersigned's capacity as an officer and/or director and/or 10% shareholder of Semler Scientific, Inc. (the “Company”), Forms 3, 4, and 5 (including amendments thereto) in accordance with Section 16(a) of the U.S. Securities Exchange Act of 1934, as amended (the “Exchange Act”) and the rules thereunder, and a Form ID, Uniform Application for Access Codes to File on EDGAR, and any other forms or reports the undersigned may be required to file in connection with the undersigned's ownership, acquisition, or disposition of securities of the Company;

(2)

do and perform any and all acts for and on behalf of the undersigned that may be necessary or desirable to complete and execute any such Form 3, 4, or 5, or Form ID or other form or report, and timely file such form or report (in each case, including amendments thereto) with the U.S. Securities and Exchange Commission and any stock exchange or similar authority; and

(3)

take any other action of any type whatsoever in connection with the foregoing that, in the opinion of such attorney-in-fact, may be of benefit to, in the best interest of, or legally required by, the undersigned, it being understood that the documents executed by such attorney-in-fact on behalf of the undersigned pursuant to the Power of Attorney shall be in such form and shall contain such terms and conditions as such attorney-in-fact may approve in such attorney-in-fact's discretion.

The undersigned hereby grants to each such attorney-in-fact full power and authority to do and perform any and every act and thing whatsoever requisite, necessary, or proper to be done in the exercise of any of the rights and powers herein granted, as fully to all intents and purposes as the undersigned might or could do if personally present, with full power of substitution or revocation, hereby ratifying and confirming all that such attorney-in-fact, or such attorney-in-fact's substitute or substitutes, shall lawfully do or cause to be done by virtue of this power of attorney and the rights and powers herein granted. The undersigned acknowledges that the foregoing attorneys-in-fact, in serving in such capacity at the request of the undersigned, are not assuming, nor is the Company assuming, any of the undersigned's responsibilities to comply with Section 16 of the Exchange Act.

The undersigned agrees that each such attorney-in-fact herein may rely entirely on information furnished orally or in writing by the undersigned to such attorney-in-fact. The undersigned also agrees to indemnify and hold harmless the Company and each such attorney-in fact against any losses, claims, damages or liabilities (or actions in these respects) that arise out of or are based upon any untrue statements or omission of necessary facts in the information provided by the undersigned to such attorney-in fact for purposes of executing, acknowledging, delivering or filing Forms 3, 4, or 5 (including amendments thereto) or Form ID.

This Power of Attorney supersedes any power of attorney previously executed by the undersigned regarding the purposes outlined in the first paragraph hereof (“Prior Powers of Attorney”), and the authority of the attorney-in-fact named in any Prior Powers of Attorney is hereby revoked.

This Power of Attorney shall remain in full force and effect until the undersigned is no longer required to file Forms 3, 4, or 5 with respect to the undersigned’s holdings of and transactions in securities issued by the Company, unless earlier (a) revoked by the undersigned in a signed writing delivered to the foregoing attorneys-in-fact or (b) superseded by a new power of attorney regarding the purposes outlined in the first paragraph hereof dated as of a later date.

IN WITNESS WHEREOF, the undersigned has caused this Power of Attorney to be executed as of this 7^th day of June, 2018.

William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006

/s/ William H.C. Chang

William H.C. Chang, Trustee