4 1 l99344ae4.htm DATATRAK INTERNATIONAL/JEFFREY A. GREEN FORM 4 DATATRAK International/Jeffrey A. Green Form 4
 

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

FORM 4

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935
or Section 30(h) of the Investment Company Act of 1940

o 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*		 2. Issuer Name and Ticker or Trading
Symbol		 3. I.R.S. Identification Number of Reporting
Person, if an entity (Voluntary)
  Green, Jeffrey A.
(Last) (First) (Middle)		   DATATRAK International, Inc. (DATA)
    
     
  6150 Parkland Blvd. #100
(Street)		 4. Statement for Month/Day/Year 5. If Amendment, Date of Original (Month/Day/Year)
    February 26, 2003
    
     
    6. Relationship of Reporting Person(s)
to Issuer (Check All Applicable)		 7. Individual or Joint/Group Filing
(Check Applicable Line)
  Mayfield Hts., OH, 44124
(City)        (State)        (Zip)		   x  Director o  10% Owner   x Form Filed by One Reporting Person
    x  Officer (give title below)   o Form Filed by More than One Reporting Person
    o  Other (specify below)  
      President & Chief Executive Officer
      
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).

 

                                               
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 Sec-
urities Beneficially
Owned Following
Reported Trans-
action(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 Shares, without par value   02/26/03     P     5000   A   0.85     199,755 (1)     D  
  Common Shares, without par value       J (2)             73,969 (3)     I   By Wife
  Common Shares, without par value       J (2)             7,269     I   By Company 401K
                         
                         
                         
                         
                         
                         
                         

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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)
                      Code V   (A) (D)
  Employee Stock Option (right to buy)     4.15     7/1/95     J (2)  
  Employee Stock Option (right to buy)     10.75     1//2/97     J (2)  
  Employee Stock Option (right to buy)     3.63     12/9/99     J (2)  
  Employee Stock Option (right to buy)     2.78     6/4/02     J (2)  
               
               
               
               
               
               

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Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)
6. Date Exercisable and
Expiration Date
(Month/Day/Year)		 7. Title and Amount
of Underlying Securities
(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 of
Derivative Security:
Direct (D) or
Indirect (I)
(Instr. 4)		 11. Nature of
Indirect
Beneficial
Ownership
(Instr. 4)
  Date
Exercisable		 Expiration
Date		   Title Amount or
Number of
Shares		                        
  4/20/99 7/1/05   Common Shares 25,000 (4)               D  
  4/20/99 1/2/07   Common Shares 25,000 (5)               D  
  12/9/03 12/9/09   Common Shares 90,000 (5)               D  
  6/4/06 6/4/12   Common Shares 22,500 (5)           162,500     D  
                   
                   
                   
                   
                   
                   

Explanation of Responses:

1. Includes 194,755 Common Shares previously reported on Form 3 or Form 4.

2. Beneficial ownership of these securities was reported on previously reported Form 4 or Form 5.

3. 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.

4. Options were granted under the Company's Amended and Restated 1992 Share Incentive Plan in reliance upon the Exemption provided by Rule 16-b-3.

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/ Jeffrey A, Green   2/27/2003
**Signature of Reporting Person		  
Date

**   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.

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