Form 3 - AFLAC Incorporated


FORM 3

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

  


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(Print or Type Responses)

1. Name and Address of Reporting Person*


Mori, Nobuhiro

2. Date of Event
    Requiring Statement
    (Month/Day/Year)

 02/28/03

4. Issuer Name and Ticker or Trading Symbol

 

AFLAC INCORPORATED (AFL)

(Last)                               (First)                            (Middle)


2-14-6, Oyamadai, Setagaya, Ku 

3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)

 

5. Relationship of Reporting Person(s) to Issuer
                         (Check all applicable)

6. If Amendment, Date of
    Original (Month/Day/Year)

11/19/02 

 X  

Director

   

10% Owner

(Street)

Tokyo, Japan 100-0086

   

Officer (give
          title below)

   

Other (specify
         below)

7. Individual or Joint/Group
    Filing (Check Applicable Line)

 

   X

Form filed by One Reporting Person

(City)                               (State)                               (Zip)

   

Form filed by More than One Reporting Person

Table I ¾ Non-Derivative Securities Beneficially Owned

1. Title of Security                                                                       
    (Instr. 4)

2. Amount of Securities
    Beneficially Owned
    (Instr. 4)

3. Ownership
    Form: Direct
    (D) or Indirect
    (I)   (Instr. 5)

4. Nature of Indirect Beneficial Ownership        
    (Instr. 5)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

*

If the form is filed by more than one reporting person, see Instruction 5(b)(v).

 

                                                                    

Persons who respond to the collection of information contained in this form are not required to
respond unless the form displays a currently valid OMB control number.

     

(Over)
SEC 1473 (7-02)

 

 

FORM 3 (continued)

Table II ¾ Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

1.Title of Derivative Security                                   
   (Instr. 4)

2.Date Exer-
   cisable and
   Expiration
   Date
   (Month/Day/Year)

3. Title and Amount of Securities Underlying                                  
    Derivative Security
    (Instr. 4)

4. Conver-
    sion or
    Exercise
    Price of
    Deri-
    vative
    Security

5. Owner-
    ship
    Form of
    Deriv-
    ative
    Security:
    Direct
    (D) or
    Indirect
    (I)
    (Instr. 5)

6. Nature of Indirect
    Beneficial Ownership
    (Instr. 5)

Date
Exer-
cisable

Expira-
tion
Date

                           Title                          

Amount
or
Number
of
Shares
               

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

  Option granted in error.

 

 

 

          

 

**

Intentional misstatements or omissions of facts constitute Federal Criminal Violations.

**Signature of Reporting Person

          

Date
 

See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

By: Patricia A. Bell
For: Nobuhiro Mori
                                                                      

          

         03/04/03                       

Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
         See Instruction 6 for procedure.

 

     

 

 

 

 

     

 

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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