-----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, BbnaRX1+/6NnCeQzbsKtKOuDihA+zGyoK0fkvtbJoEBRwm/990lPPsvnz9eXi3zz SQgW2vaFWvq0NRW2f7J9ew== 0001209191-08-035443.txt : 20080605 0001209191-08-035443.hdr.sgml : 20080605 20080605170253 ACCESSION NUMBER: 0001209191-08-035443 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20080603 FILED AS OF DATE: 20080605 DATE AS OF CHANGE: 20080605 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DATATRAK INTERNATIONAL INC CENTRAL INDEX KEY: 0000886530 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] 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: 6150 PARKLAND BLVD STREET 2: STE 100 CITY: MAYFIELD HEIGHTS STATE: OH ZIP: 44124 FORMER COMPANY: FORMER CONFORMED NAME: COLLABORATIVE CLINICAL RESEARCH INC DATE OF NAME CHANGE: 19960311 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: GREEN JEFFREY A CENTRAL INDEX KEY: 0001105840 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33688 FILM NUMBER: 08883681 BUSINESS ADDRESS: BUSINESS PHONE: 2169216505 MAIL ADDRESS: STREET 1: 20600 CHAGRIN BLVD CITY: CLEVELAND STATE: OH ZIP: 44122 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2008-06-03 0 0000886530 DATATRAK INTERNATIONAL INC DATA 0001105840 GREEN JEFFREY A 6150 PARKLAND BLVD. SUITE 100 MAYFIELD HTS. OH 44124 1 1 0 0 President and CEO Common Shares, without par value 2008-06-03 4 P 0 5000 0.54 A 298832 D Common Shares, without par value 110953 I By Wife Common Shares, without par value 1450 I By Son Common Shares, without par value 1500 I By Daughter Common Shares, without par value 1500 I By Daughter Employee Stock Option (right to buy) 7.17 1999-04-20 2007-01-02 Common Shares 37500 37500 D Employee Stock Option (right to buy) 2.42 2003-12-09 2009-12-09 Common Shares 130000 167500 D Employee Stock Option (right to buy) 1.85 2006-06-04 2012-06-04 Common Shares 33750 201250 D Employee Stock Option (right to buy) 4.05 2005-12-23 2013-12-23 Common Shares 1500 202750 D Employee Stock Option (right to buy) 4.05 2007-12-23 2013-12-23 Common Shares 15000 217750 D Employee Stock Option (right to buy) 7.35 2008-12-28 2014-12-28 Common Shares 18000 235750 D No transaction is being reported on this line. Reported on a previously filed Form 3, Form 4 or Form 5. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is a beneficial owner of such securities for purposes of Section 16 or for any other purpose. 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 16b-3. /s/ Jeffrey A. Green, by Arthur C. Hall III, his attorney-in-fact, pursuant to Power of Attorney dated October 28, 2005, on file with the Commission. 2008-06-05 -----END PRIVACY-ENHANCED MESSAGE-----