-----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, Czy2DXn4WaaKn4nAucSbdCD+PiVwIYVTaSfnf97FgnRbI8ZhwLTu/ET5uox6hbHm lZfMvc14JTRBiBRQLy3pcg== 0001209191-09-042415.txt : 20090828 0001209191-09-042415.hdr.sgml : 20090828 20090828153812 ACCESSION NUMBER: 0001209191-09-042415 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090826 FILED AS OF DATE: 20090828 DATE AS OF CHANGE: 20090828 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Merk Raymond J. CENTRAL INDEX KEY: 0001408826 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33688 FILM NUMBER: 091043232 MAIL ADDRESS: STREET 1: 6150 PARKLAND BLVD. STREET 2: SUITE 100 CITY: MAYFIELD HEIGHTS STATE: OH ZIP: 44124 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 4 1 doc4.xml FORM 4 SUBMISSION X0303 4 2009-08-26 0 0000886530 DATATRAK INTERNATIONAL INC DATA 0001408826 Merk Raymond J. 6150 PARKLAND BLVD. SUITE 100 MAYFIELD HEIGHTS OH 44124 0 1 0 0 VP of Finance,CFO & Treasurer Common Shares, without par value 4639 D Employee Stock Option (Right to Buy) 0.37 2018-08-11 Common Shares 40000 40000 D Employee Stock Option (Right to Buy) 0.23 2009-08-26 4 A 0 172500 0.00 A 2019-06-09 Common Shares 172500 212500 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 2005 Omnibus Equity Plan in reliance upon the exemption provided by Rule 16b-3. The options become exercisable in 1/3 increments over three years beginning on the first anniversay of the date of grant. Options were granted under the Company's 2009 Omnibus Equity Plan in reliance upon the exemption provided by Rule 16b-3. The options vest ratably over a three-year period beginning on the first anniversay of the date of grant. /s/ Raymond J. Merk, by Arthur C. Hall III, his attorney-in-fact, pursuant to Power of Attorney, dated August 10, 2007, on file with the Commission 2009-08-28 -----END PRIVACY-ENHANCED MESSAGE-----