U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
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
Holding Company Act of 1935 or Section 30(f) of the
Investment Company Act of 1940
( ) Check this box if no longer subject to Section 126. Form 4 or Form 5
obligations may continue.
See Instruction 1(b).
( X ) Form 3 Holdings Reported
( ) Form 4 Transactions Reported
1. Name and Address of Reporting Person
LAN CHARLIE
----------------------------------------------------
(Last) (First) (Middle)
#41, 5950 OAKDALE ROAD
----------------------------------------------------
(Street)
BURNABY BRITISH COLUMBIA CANADA V5R 4R5
----------------------------------------------------
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
AMANASU TECHNOLOGIES CORPORATION
------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Day/Year
12/31/02
5. If Amendment, Date of Original (Month/Day/Year)
6. Relationship of Reporting Person to Issuer (Check all applicable)
X Director 10% Owner
X Officer (Give title below) Other (specify below)
CHAIRMAN, PRESIDENT, CHIEF EXECUTIVE OFFICER
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
6. Owner- 7. Nature
5. Amount of ship of In-
2. Trans Securities Form: direct
action Date 4. Securities Acquired Beneficially Direct Bene-
3. Trans- or Disposed of (D) Owned at (D) or ficial
(Month/ action Code (Instr. 3, 4 & 5) End of Indirect Owner-
Day/ (Instr. 8) Month (I) ship
1. Title of Security (Instr. 3) Year) Code V Amount (A) or Price (Inst. 3&4) (Inst.4) (Inst.4)
(D)
Common Shares N/A N/A 3 N/A N/A N/A 275,000 D
------------------------------- --------- ------- ----- ------ ----- ------ ------------ -------- ----------
------------------------------- --------- ------- ----- ------ ----- ------ ------------ -------- ----------
------------------------------- --------- ------- ----- ------ ----- ------ ------------ -------- ----------
------------------------------- --------- ------- ----- ------ ----- ------ ------------ -------- ----------
TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
6.
Date
Exer- 9. 10.
5. cisable 7. Number Owner-
Number of and Ex- Title and of ship
Deriva piration Amount of Deriv- Form 11. Na-
tive Date Underlying 8. ative of De- ture
securities (Month/ Securities Price Secur- rivative of In-
2. Conver- Acquired Day/ (Instr.3 of ities Secur- direct
sion or 3. Trans- 4. (A) or Year) and 4) Deriva- Bene- ity: Bene-
Exercise action Trans- Disposed Date Amount ative fically Direct ficial
1. Title of Price of Date action of (D) Ex- Ex- or Secur- Owned (D) or Owner-
Derivative Deriv- (Month/ Code (Instr.3, er- pira- Number ity . at End Indi- ship
Security ative Day/ (Instr.8) 4 and 5) cis- tion of (Instr of Month rect (I) (Instr.
Instr.3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr.4) (Inst 4) 4)
------------ -------- -------- --- --- ----- ------ ------- ------- ------ ------ ------ -------- ------- -------
N/A
------------ -------- -------- --- --- ----- ------ ------- ------- ------ ------ ------ -------- ------- -------
------------ -------- -------- --- --- ----- ------ ------- ------- ------ ------ ------ -------- ------- -------
------------ -------- -------- --- --- ----- ------ ------- ------- ------ ------ ------ -------- ------- -------
Explanation of Responses:
"Charlie Lan" March 18, 2003
--------------------- -------------------
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).
Note: File three copies of this Form, one of which must be manually signed. If
space provided is insufficient, see Instruction 6 for procedure.