-------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION --------------------------------- FORM 5 WASHINGTON, D.C. 20549 OMB APPROVAL -------------------- --------------------------------- ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0362 / / Check box if no longer subject to Expires: January 31, 2005 Section 16. Form 4 or Form 5 Estimated average burden obligations may continue. hours per response . . . . . 1.0 See Instruction 1(b). --------------------------------- / / Form 3 Holdings Reported 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 / / Form 4 Transactions Reported ----------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer Person* (Check all applicable) X Director __10% Owner __Officer (give title below) __Other Reinsurance Group of America, (specify below) Peck William A. Incorporated (NYSE:RGA) --------------------------------- --------------------------------------------- ------------------------------ (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for Washington University Number of Reporting Month/Year Campus Box 8106 Person, if an entity 660 South Euclid Avenue (Voluntary) December 2002 --------------------------------- ----------------- -------------------------------------------------- (Street) 5. If Amendment, 7. Individual or Joint/Group Reporting Date of (check applicable line) Original X Form Filed by One Reporting Person (Month/Year) __Form Filed by More than One Reporting Person St. Louis Missouri 63110-1093 --------------------------------- -------------------------- ---------------- -------------------------------------------------- (City) (State) (Zip) =================================================================================================================================== TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED =================================================================================================================================== 1. Title of 2. Trans- 2A. Deemed 3. Trans- 4. Securities Acquired (A) or 5. Amount of 6. Ownership 7. Nature of Security action Execu- action Disposed of (D) (Instr. 3, 4 Securities Form: Indirect (Instr. 3) Date tion Code and 5) Beneficially Direct Beneficial (Month/ Date, (Instr. Owned at the (D) or Ownership Day/ if any 8) ------------------------------- end of Indirect (Instr. 4) Year) (Month/ (A) or Issuer's (I) Day/ Amount (D) Price Fiscal Year (Instr. 4) Year) (Instr. 3 and 4) ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================*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) ==================================================================================================================================== 9. 10. Number of Owner- Deriv- ship 2. ative Form of Conver- 5. 7. Secu- Deriv- 11. sion Number of Title and Amount rities ative Nature or 3A. Derivative 6. of Underlying 8. Bene- Secu- of Exer- Deemed 4. Securities Date Securities Price ficially rity: In- cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Owned Direct direct Price Trans- tion action or Disposed Expiration Date ---------------- Deriv- at End (D) Bene- 1. of action Date, Code of (D) (Month/Day/Year) Amount ative of Year or In- ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secu- (Instr. direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number rity 4) (I) ship Security Secu- Day/ Day/ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. 3) rity Year) Year) (A) (D) cisable Date Title Shares 5) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Stock $31.25 5/22/02 A 3,000 5/22/03 5/22/12 Common 3,000 3,000 D Option Stock (right to purchase) ------------------------------------------------------------------------------------------------------------------------------------ Phantom 1-for-1 (1) A 30.6 (1) (1) Common 30.6 30.6 D Stock Stock Dividend Equivalent Right ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: (1) Acquired on quarterly dividend record dates during 2002. Rights become vested and expire proportionately with the phantom shares to which they relate. William L. Hutton December 10, 2002 ---------------------------------------------------------- ---------------------------------- **Signature of Reporting Person Date Attorney-in-fact ** 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.