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FORM 10-C
Securities and Exchange Commission
Washington, DC 20549
Report by issuer of securities quoted on The Nasdaq Stock Market(SM), filed
pursuant to Section 13 or 15(d) of the Securities Exchange Act of 1934 and Rule
13a-17 or 15d-17 thereunder.
EXACT NAME OF ISSUER AS SPECIFIED IN CHARTER: ChemTrak Incorporated
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929 East Arques Avenue,
ADDRESS OF PRINCIPAL EXECUTIVE OFFICES: Sunnyvale, CA 94086
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ISSUER'S TELEPHONE NUMBER (INCLUDING AREA CODE): (408) 773-8156
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I. Change in Number of Shares Outstanding
Indicate any change (increase or decrease) of five percent or more in the
number of shares outstanding:
1. Title of Security Common Stock
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2. Number of shares outstanding after the change 9,750,272
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3. Number of shares outstanding after the change 11,698,372
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4. Effective date of change 6/27/96 - 6/27/98
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5. Method of change Conversion of convertible debentures
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Specify method (such as merger, acquisition, exchange, distribution, stock
split, reverse split, acquisition of stock for treasury, etc.)------------------
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up to $5,000,000 in convertible
debentures issued 5/13/96 Conversions
Give brief description of transaction over a 2 year period beginning 6/27/96.
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II. Change in Name of Issuer
1. Name prior to change
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2. Name after change
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3. Effective date of charter amendment changing name
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4. Date of shareholder approval of change, if required
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/s/ PRITHIPAL BINGH, Ph.D.
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DATE OFFICER'S SIGNATURE AND TITLE
May 22, 1996 Prithipal Bingh, Ph.D.
Chairman of the Board and Chief Executive Officer
(c) June 1994, The Nasdaq Stock Market, Inc. All rights reserved, Nasdaq is a
registered service mark of The Nasdaq Stock Market, Inc. The Nasdaq Stock
Market is a service mark of The Nasdaq Stock Market, Inc.
