0001036262-18-000001.txt : 20180130 0001036262-18-000001.hdr.sgml : 20180130 20180130151504 ACCESSION NUMBER: 0001036262-18-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20171231 FILED AS OF DATE: 20180130 DATE AS OF CHANGE: 20180130 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MATTHIESSEN ROBERT E CENTRAL INDEX KEY: 0001051994 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-36117 FILM NUMBER: 18558740 MAIL ADDRESS: STREET 1: C/O INTEST CORP STREET 2: 804 EAST GATE DRIVE, SUITE 200 CITY: MT. LAUREL STATE: NJ ZIP: 08054 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: INTEST CORP CENTRAL INDEX KEY: 0001036262 STANDARD INDUSTRIAL CLASSIFICATION: INSTRUMENTS FOR MEAS & TESTING OF ELECTRICITY & ELEC SIGNALS [3825] IRS NUMBER: 222370659 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 804 EAST GATE DR., SUITE 200 CITY: MT. LAUREL STATE: NJ ZIP: 08054 BUSINESS PHONE: 856-505-8800 MAIL ADDRESS: STREET 1: 804 EAST GATE DR., SUITE 200 CITY: MT. LAUREL STATE: NJ ZIP: 08054 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2017-12-31 0 0001036262 INTEST CORP INTT 0001051994 MATTHIESSEN ROBERT E C/O INTEST CORP 804 EAST GATE DRIVE, SUITE 200 MT. LAUREL NJ 08054 1 0 0 0 Common Stock 2017-12-31 4 D 0 18700 0 D 86481 D Common Stock 61618 I By Spouse Employee Stock Option (right to buy) 4.37 2017-12-31 4 D 0 5400 0 D Common Stock 5400 1800 D Employee Stock Option (right to buy) 6.35 2017-12-31 4 D 0 34000 0 D Common Stock 34000 0 D The shares disposed are unvested restricted shares forfeited as a result of the reporting person's retirement as President and CEO on 12/31/17. Of the total shares forfeited, 7,200 shares (75%) are from the 1/22/16 restricted stock award grant and 11,500 (100%) are from the 3/15/17 restricted stock award granted to the reporting person. The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed to be an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. The options disposed are unvested employee stock options forfeited as a result of the report person's retirement on 12/31/17. The option is 25% vested and exercisable, but will expire on 12/31/18, the one year anniversary of the reporting person's retirement. The options disposed are unvested employee stock options forfeited as a result of the reporting person's retirement on 12/31/17. The option was completely unvested and therefore was 100% forfeited as of 12/31/17. /s/ Hugh T. Regan, Jr., Attorney-in-Fact for Robert E. Matthiessen 2018-01-30