SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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).
1. Name and Address of Reporting Person*
WILSON R G

(Last) (First) (Middle)
MICROTEK MEDICAL HOLDINGS, INC.
13000 DEERFIELD PKWY., STE. 300

(Street)
ALPHARETTA GA 30004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MICROTEK MEDICAL HOLDINGS, INC [ MTMD ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
VP, CFO and Treasurer
3. Date of Earliest Transaction (Month/Day/Year)
11/09/2007
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 11/09/2007 D 66,275(1) D $6.3(2) 0 D
Common Stock 11/09/2007 D 23,452 D $6.3(2) 0 I By 401(k) Plan
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option $2.2813 11/09/2007 D 15,000 (3) 05/26/2008 Common Stock 15,000 $0 0 D
Stock Option $2.125 11/09/2007 D 5,000 (3) 02/25/2009 Common Stock 5,000 $0 0 D
Stock Option $1.1875 11/09/2007 D 6,250 (3) 11/30/2010 Common Stock 6,250 $0 0 D
Stock Option $1.66 11/09/2007 D 75,000 (3) 05/16/2011 Common Stock 75,000 $0 0 D
Stock Option $1.9 11/09/2007 D 75,000 (3) 08/07/2012 Common Stock 75,000 $0 0 D
Stock Option $2.25 11/09/2007 D 75,000 (3) 02/01/2013 Common Stock 75,000 $0 0 D
Stock Option $3.59 11/09/2007 D 75,000 (3) 08/01/2013 Common Stock 75,000 $0 0 D
Stock Option $5.02 11/09/2007 D 75,000 (3) 02/02/2014 Common Stock 75,000 $0 0 D
Stock Option $3.99 11/09/2007 D 75,000 (3) 08/02/2014 Common Stock 75,000 $0 0 D
Explanation of Responses:
1. Includes shares acquired through Microtek Medical Holdings, Inc. Employee Stock Purchase Plan up to November 6, 2007.
2. Disposed of pursuant to a merger agreement among Microtek Medical Holdings, Inc., Magic Acquisition Inc. and Ecolab Inc. in exchange for merger consideration of $6.30 per share in accordance with the terms of the merger agreement on the effective date of the merger.
3. This option was canceled in the merger in exchange for a cash payment equal to the difference between the aggregate merger consideration for the shares subject to the option and the aggregate exercise price of the option.
Remarks:
/s/ Roger G. Wilson 11/09/2007
** 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.