-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, P8KbORMzV0DsOv3NxR/5x77PC+EEMQhzf2PBgH7PPWuKMIMAyef3POcJvxSqbFyO dQzNLzS9GwxMIxnMRPi/dw== 0001209191-04-015738.txt : 20040315 0001209191-04-015738.hdr.sgml : 20040315 20040315110319 ACCESSION NUMBER: 0001209191-04-015738 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040312 FILED AS OF DATE: 20040315 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHLAES MARC J CENTRAL INDEX KEY: 0001265213 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20699 FILM NUMBER: 04668133 BUSINESS ADDRESS: STREET 1: 6150 PARKLAND BLVD STREET 2: #100 CITY: MAYFIELD HEIGHTS STATE: OH ZIP: 44124 BUSINESS PHONE: 4404430082X110 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DATATRAK INTERNATIONAL INC CENTRAL INDEX KEY: 0000886530 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMMERCIAL PHYSICAL & BIOLOGICAL RESEARCH [8731] IRS NUMBER: 341685364 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6150 PARKLAND BLVD STREET 2: SUITE 100 CITY: MAYFIELD HEIGHTS STATE: OH ZIP: 44124 BUSINESS PHONE: 4404430082 MAIL ADDRESS: STREET 1: 20600 CHAGRIN BLVD STREET 2: STE 1050 CITY: CLEVELAND STATE: OH ZIP: 44122 FORMER COMPANY: FORMER CONFORMED NAME: COLLABORATIVE CLINICAL RESEARCH INC DATE OF NAME CHANGE: 19960311 4 1 bcl06392_bcl1mjs.xml MAIN DOCUMENT DESCRIPTION X0201 4 2004-03-12 0 0000886530 DATATRAK INTERNATIONAL INC DATA 0001265213 SHLAES MARC J 6150 PARKLAND BLVD. # 100 MAYFIELD HTS. OH 44124 0 1 0 0 Vice President - Development Common Shares, without par value 2004-03-12 4 S 0 2000 8.00 D 500 D Common Shares, without Par value 2004-03-12 4 S 0 500 8.01 D 0 D Employee stock option (right to buy) 4.50 1998-07-15 4 J 0 12000 0.00 A 1999-04-20 2008-07-15 Common Shares 12000 12000 D Employee stock option (right to buy) 3.75 1999-09-22 4 J 0 30000 0.00 A 2003-09-22 2009-09-22 Common Shares 30000 42000 D Employee stock option (right to buy) 3.63 1999-12-09 4 J 0 15000 0 A 2003-12-09 2009-12-09 Common Shares 15000 57000 D Employee stock option (right to buy) 2.78 2002-06-04 4 J 0 6875 0.00 A 2006-06-04 2012-06-04 Common Shares 6875 63875 D Employee stock option (right to buy) 6.07 2003-12-23 4 J 0 1000 0.00 A 2005-12-23 2013-12-23 Common Shares 1000 64875 D Employee stock option (right to buy) 6.07 2003-12-23 4 J 0 6000 0.00 A 2007-12-23 2003-12-23 Common Shares 6000 70875 D Beneficial ownership of these securities was reported on a previously filed Form 3, Form 4 or Form 5. Options were granted under the Company's Amended and Restated 1996 Key Employees and Consultants Stock Option Plan in reliance upon the Exemption provided by Rule 16-b-3. /s/ Marc J. Shlaes 2004-03-15 -----END PRIVACY-ENHANCED MESSAGE-----