FORM 5 |
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION ANNUAL 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 |
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Check this box if no longer subject to |
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Form 3 Holdings Reported |
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Form 4 Transactions Reported |
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1. Name and Address of Reporting Person* Chuaychoo, Monthon |
2. Issuer Name and Ticker or Trading Symbol AFLAC INCORPORATED (AFL) |
6. Relationship of Reporting Person(s) to Issuer |
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Director |
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10% Owner |
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X |
Officer (give |
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Other (specify |
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Vice President |
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(Last) (First) (Middle) 3 Spaniel Court |
3. I.R.S. Identification
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4. Statement for Month/Year 12/31/2002 |
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5. If Amendment, Date of
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X |
Form Filed by One Reporting Person |
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(Street) Columbus, GA 31909 |
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Form Filed by More than One Reporting Person |
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(City) (State) (Zip) |
Table I ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Trans- |
2A. Deemed |
3. Trans- |
4. Securities Acquired (A) or |
5. Amount of |
6. Owner- |
7. Nature of |
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Amount |
(A) or |
Price |
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Common Stock |
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16,528 |
D |
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Common Stock |
12/31/02 |
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I |
49 (1) |
A |
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7,084 |
I |
401(K) Plan |
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Common Stock |
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7,397 |
I |
Spouse |
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* |
If the form is filed by more than one reporting person, see instruction 4(b)(v). |
Persons who respond to the collection of information contained in |
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(Over) |
FORM 5 (continued) |
Table II ¾
Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Derivative |
2. Conver- |
3. Trans |
3A. Deem |
4. Trans- |
5. Number of Deriva- |
6. Date Exercis- |
7. Title and Amount of Underly- |
8. Price |
9. Number |
10. Owner- |
11. Nature of |
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(A) |
(D) |
Date |
Expira- |
Title |
Amount or |
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Stock Units |
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12/31/02 (2) |
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I |
3 |
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(2) |
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Common Stock |
3 |
(2) |
818 |
D |
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Explanation of Responses: |
(1) Between January 1, 2002 and December 31, 2002, the reporting person acquired 49 shares of AFLAC Incorporated Commons Stock under the AFLAC Incorporated 401(k) plan. The information in this report is based on a plan statement dated as of December 31, 2002. (2) The phantom stock units were accrued under AFLAC Incorporated's Executive Deferred Compensation Plan (EDCP). The EDCP holds Stock Units on the reporting party's behalf representing the value of the Common Stock. The stock units were accrued between 01/01/02 and 06/06/02 at prices ranging from $27.2407 to $31.1944. |
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** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
**Signature of Reporting Person |
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Date |
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See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
By: Patricia A. Bell |
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Note: File three copies of this Form, one of which must be manually signed. |
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Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
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Page 2 |
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SEC2270 (9-02) |