SEC Form 4/A · accession 0001571049-17-007924
Semler Scientific, Inc. · SMLR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Period of report
Jun 14, 2017
Accepted (ET)
Sep 15, 2017 · 4:52 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001554859
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Jun 14, 2017 | M | 150,000 | $0.52 | A | 150,000 | D | |
| Common StockF3 | holding | — | — | — | 378,064 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option (right to buy) | $0.52 | Jun 14, 2017 | M | 150,000 | A | Jan 1, 2008 | Jan 1, 2018 | Common Stock | 150,000 | 0 | D |
Explanation of responses
- F1This amendment is being filed to correct the previously reported number of shares reported in Column 5. The correct number is 150,000.
- F2This option was held directly by Dr. Herbert J. Semler.
- F3These securities are held in family trusts and may be deemed to be beneficially owned by the reporting persons as beneficiaries and Co-Trustees of such trusts.