0001571049-18-000496.txt : 20181003
0001571049-18-000496.hdr.sgml : 20181003
20181003142050
ACCESSION NUMBER: 0001571049-18-000496
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20181001
FILED AS OF DATE: 20181003
DATE AS OF CHANGE: 20181003
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: 181104623
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: 181104624
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
tv504066_4.xml
FORM 4
X0306
4
2018-10-01
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 COURT, SUITE 110
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
2018-10-01
4
X
0
134616
2.60
A
1400419
D
Common Stock Warrant (Right to Buy)
2.60
2018-10-01
4
X
0
134616
0
D
2017-05-02
2022-01-21
Common Stock
134616
0
D
William H.C. & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006, by /s/ William H.C. Chang, Trustee
2018-10-03
/s/ William H. Chang
2018-10-03