SEC FORM 5

SEC FORM 5 SEC Form 5

FORM 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940

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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

Form 3 Holdings Reported.

Form 4 Transactions Reported.

1. Name and Address of Reporting Person^*

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

(Last)

(First)

(Middle)

C/O SEMLER SCIENTIFIC, INC.

2340-2348 WALSH AVENUE, SUITE 2344

(Street)

SANTA CLARA

95051

(City)

(State)

(Zip)

2. Issuer Name and Ticker or Trading Symbol
Semler Scientific, Inc. [ SMLR ]

5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

Director	X	10% Owner
Officer (give title below)		Other (specify below)

3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2022

4. If Amendment, Date of Original Filed (Month/Day/Year)

6. Individual or Joint/Group Filing (Check Applicable Line)

	Form filed by One Reporting Person
X	Form filed by More than One Reporting Person

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)	4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5)			5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4)	6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Security (Instr. 3)	2. Transaction Date (Month/Day/Year)	2A. Deemed Execution Date, if any (Month/Day/Year)	3. Transaction Code (Instr. 8)	Amount	(A) or (D)	Price		6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	7. Nature of Indirect Beneficial Ownership (Instr. 4)
Common Stock	09/30/2022		G	189,522	D	$0	105,582	D⁽¹⁾
Common Stock	09/30/2022		G	189,522	D	$0	105,582	D⁽²⁾
Common Stock	09/30/2022		G	238,248	A	$0	522,237	D⁽³⁾
Common Stock	11/02/2022		G	150,000	A	$0	255,582	D⁽¹⁾
Common Stock	11/02/2022		G	150,000	A	$0	255,582	D⁽²⁾
Common Stock	11/02/2022		G	300,000	D	$0	222,237	D⁽³⁾
Common Stock	11/04/2022		G	105,582	D	$0	150,000	D⁽⁴⁾
Common Stock	11/04/2022		G	105,582	D	$0	150,000	D⁽⁵⁾
Common Stock	11/04/2022		G	119,754	A	$0	341,991	D⁽³⁾
Common Stock							241,508	I⁽⁶⁾	Through LP

Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)	5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)		6. Date Exercisable and Expiration Date (Month/Day/Year)		7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4)		8. Price of Derivative Security (Instr. 5)	9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)	10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)
1. Title of Derivative Security (Instr. 3)	2. Conversion or Exercise Price of Derivative Security	3. Transaction Date (Month/Day/Year)	3A. Deemed Execution Date, if any (Month/Day/Year)	4. Transaction Code (Instr. 8)	(A)	(D)	Date Exercisable	Expiration Date	Title	Amount or Number of Shares	8. Price of Derivative Security (Instr. 5)		10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)	11. Nature of Indirect Beneficial Ownership (Instr. 4)

1. Name and Address of Reporting Person^*

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

(Last)

(First)

(Middle)

C/O SEMLER SCIENTIFIC, INC.

2340-2348 WALSH AVENUE, SUITE 2344

(Street)

SANTA CLARA

95051

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Chang William H

(Last)

(First)

(Middle)

C/O SEMLER SCIENTIFIC, INC.

2340-2348 WALSH AVENUE, SUITE 2344

(Street)

SANTA CLARA

95051

(City)

(State)

(Zip)

1. Name and Address of Reporting Person^*

Chang Diana Shon

(Last)

(First)

(Middle)

C/O SEMLER SCIENTIFIC, INC.

2340-2348 WALSH AVENUE, SUITE 2344

(Street)

SANTA CLARA

95051

(City)

(State)

(Zip)

Explanation of Responses:

1. Shares held in six GRATs, for which Mr. Chang acts as sole Trustee and has voting and investment control.

2. Shares held in six GRATs, for which Mrs. Chang acts as sole Trustee and has voting and investment control.

3. Shares are held directly by William H.C. Chang & Diana Shon Chang TTEE Chang Family Trust U/A DTD 10/23/2006.

4. Shares are held in three GRATs, for which Mr. Chang acts as sole Trustee and has voting and investment control.

5. Shares are held in three GRATs, for which Mrs. Chang acts as sole Trustee and has voting and investment control.

6. Shares are held in Chang 2020 Delaware LP.

	/s/ William H.C. Chang, Co-Trustee	02/14/2023
	/s/ William H.C. Chang	02/14/2023
	/s/ Diana Shon Chang	02/14/2023
	** Signature of Reporting Person	Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

SEC Form 5: William H.C. Chang & Diana Shon Chang Ttee Chang Family Trust U/A Dtd 10/23/2006 gifted 890,208 shares and received a gift of 658,002 shares