- ------------ U.S. SECURITIES AND EXCHANGE COMMISSION --------------------------- |F O R M 5 | Washington, D.C. 20549 | OMB APPROVAL | - ------------ --------------------------- ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0362| [ ] Check this box if |Expires: October 31, 2001 | no longer subject Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, | Estimated average burden | to Section 16. Section 17(a) of the Public Utility Holding Company Act of 1935 or | hours per response....1.0 | [ ] Form 3 Holdings Reported Section 30(f) of the Investment Company Act of 1940 --------------------------- [ ] Form 4 Holdings Reported - ----------------------------------------------------------------------------------------------------------------------------------- |1. Name & Address of Reporting Person |2.Issuer Name & Ticker or Trading Symbol |6. Relationship of Reporting Person to Issuer| | | | (Check all Applicable) | | Stone William M. | inTEST Corporation (INTT) | | | | | X Director 10% Owner | |---------------------------------------|-------------------------------------------| --- --- | | (Last) (First) (MI) |3.IRS or Soc. Sec. No.|4. Statement for | X Officer Other | | | of Reporting Person | Month/Year | --- (Give title below) --- (Specify below)| | c/o inTEST Corporation | (Voluntary) | | | | 7 Esterbrook Lane | | December 31, 2000 | President and CEO of Temptronic Corporation| |---------------------------------------| |--------------------|---------------------------------------------| | (Street) | |5. If Amendment, |7. Individual or Joint/Group Filing | | | | Date of | (Check Applicable Line) | | | | Original | | | | | (Month/Year) | X Form filed by One Reporting Person | | | | | --- | | | | | Form filed by More than One Reporting | | Cherry Hill NJ 08003 | | | --- Person | |---------------------------------------|----------------------|--------------------|---------------------------------------------| | (City) (State) (Zip) | | Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |---------------------------------------------------------------------------------------------------------------------------------| |1.Title of Security |2.Transaction |3.Transaction|4.Securities Acquired (A) |5.Amount of |6.Ownership |7. Nature of Indirect | | (Instr. 3) | Date (M/D/Y)| Code | or Disposed of (D) | Securities | Form: | Beneficial | | | | (Instr. 8) | (Inst. 3, 4 and 5) | Beneficially | Direct (D)| Ownership | | | |-------------|--------------------------| Owned at End | or In- | (Instr. 4) | | | | | |(A)| | of Issuer's | direct(I) | | | | | Code | Amount |(D)| Price | Fiscal Year | (Instr. 4)| | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | || | | | | | Common Stock | | | | | | 4,625 | D | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | Common Stock | | | | | | 3,939(1) | I |By Equity Participation| | | | | | | | | | Plan Trust | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| | | | | | | | | | | |---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------| PAGE 1 OF 2
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ----------------------------------------------------------------------------------------------------------------------------------- |1.Title of |2.Conver- |3.Trans-|4.Trans-|5.Number of|6.Date Exer-|7.Title & Amount |8.Price of |9.Number of |10.Owner-|11.Nature| | Derivative| sion or | action | action| Derivative| cisable and| of Underlying | Derivative| Derivative | ship | of In- | | Security | Exercise | Date | Code | Securities| Expiration | Securities | Security | Securities | Form of| direct | | (Instr. 3)| Price of | (M/D/Y)|(Inst.8)| Acquired | Date(M/D/Y)| (Instr. 3 and 4)| (Instr. 5)|Beneficially| Deriva- | Benefi-| | |Derivative| | |(A) or Dis-|------------|-----------------| | Owned at | tive | cial | | |Security | | |posed of(D)|Date | | | | | End of | Security| Owner- | | | | |--------|-----------|Exer-|Expir-| |Amount or| | Year | Direct | ship | | | | | | | |cisa-|ation | |Number of| | (Instr. 4) | (D) or |(Instr 4)| | | | | Code | (A) |(D) | ble | Date |Title | Shares | | |(Instr.4)| | |------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------| | | | | | | | | | | | | | | | |Employee | | | | | | | | | | | | | | |Stock Option| $12.6875 | 8/4/00 | A |60,000| | (2) |8/3/10| Common| 60,000 | | 60,000 | D | | |(Right to | | | | | | | | Stock| | | | | | | buy) | | | | | | | | | | | | | | |------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------| | | | | | | | | | | | | | | | |------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------| | | | | | | | | | | | | | | | |------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------|
Explanation of Responses: (1) The information regarding shares owned by the Equity Participation Plan is based upon a statement of EPP holdings dated as of September 30, 2000. (2) First 20% exercisable on the Date of Grant; thereafter annual increments of 20% beginning on August 4, 2001. /s/William M. Stone 2/12/2001 - ------------------------------------------ -------------- **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). PAGE 2 OF 2