- ------------ 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
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|1. Name & Address of Reporting Person |2.Issuer Name & Ticker or Trading Symbol |6. Relationship of Reporting Person to Issuer|
| | | (Check all Applicable) |
| Bortnem Jerome R. | inTEST Corporation (INTT) | |
| | | 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 | Vice President, Sales and Marketing |
|---------------------------------------| |--------------------|---------------------------------------------|
| (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)| |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | || | | | |
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
| | | | | | | | | |
|---------------------|--------------|-------------|------------|---|---------|--------------|------------|-----------------------|
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* 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)
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|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 | | | | | | | | Common| | | | | |
|Stock Option| $10.00 | 8/11/00| A |40,000| | (1) |8/10/10 Stock| 40,000 | | 40,000 | D | |
|(Right to | | | | | | | | | | | | | |
| Buy) | | | | | | | | | | | | | |
|------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------|
| | | | | | | | | | | | | | |
|------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------|
| | | | | | | | | | | | | | |
|------------|----------|--------|--------|------|----|-----|------|-------|---------|-----------|------------|---------|---------|
Explanation of Responses:
(1) Exercisable in annual increments of 20% beginning on August 11, 2001.
/s/Jerome R. Bortnem 2/12/2001
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**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).
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