------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0362 Expires: January 31, 2005 Estimated average burden hours per response.........1.0 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 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 Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |X| Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |X| Form 3 Holdings Reported |X| Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Investor Communications International, Inc. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 435 Martin Street, Suite 2000 - -------------------------------------------------------------------------------- (Street) Blaine, Washington 98230 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol GeneMax Corp. "GMXX" - -------------------------------------------------------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) n/a - -------------------------------------------------------------------------------- 4. Statement for Month/Year December 2002 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) n/a - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) |_| Director |_| 10% Owner |_| Officer (give title below) |X| Other (specify below) no current relationship --------------------------------- - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (check applicable line) |X| Form filed by One Reporting Person |_| Form filed by More than One Reporting Person - --------------------------------------------------------------------------------================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================ 5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship 2A. 3. Disposed of (D) Beneficially Form: 7. 2. Deemed Transaction (Instr. 3, 4 and 5) Owned Direct Nature of Trans- Execution Code ------------------------------- at the End (D) or Indirect 1. action Date, if (Instr. 8) (A) of Issuer's Indirect Beneficial Title of Security Date any ------------ or Fiscal Year (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) Amount (D) Price (Instr. 3 & 4) (Instr.4) (Instr.4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock $0.001 par value 554,470 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== - ---------- * If the form is filed by more than one reporting person, see instruction 4(b)(v).
FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================ 10. 9. Owner- Number ship 2. of of Conver- 5. 7. Deriv- Deriv- 11. sion Number of Title and Amount ative ative Nature or Derivative 6. of Underlying 8. Secur- Secur- of Exer- 3A. 4. Securities Date Securities Price ities ity: In- cise Deemed Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Bene- Direct direct Price 3. Execut- action or Disposed Expiration Date ---------------- Deriv- ficially (D) or Bene- 1. of Trans- ion Code of(D) (Month/Day/Year) Amount ative Owned In- ficial Title of Deriv- action Date if (Instr. (Instr. 3, ---------------- or Secur- at End direct Owner- Derivative ative Date any 8) 4 and 5) Date Expira- Number ity of Year (I) ship Security Secur- (mm/dd/ (mm/dd/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity yy) yy) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Options $0.50 12/03/02 C * 102,000 07/15/02 07/15/04 Stock 102,000 $0.50 898,000 D n/a - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: * Pursuant to a Notice and Agreement of Exercise of Option dated December 3, 2002, Brent Pierce ("Pierce") who is a contractor to Investor Communications International, Inc. ("ICI"), exercised 102,000 stock options at the exercise price of $0.50 per option to acquire 102,000 shares of the common stock of GeneMax Corp. ("GMXX"). Pursuant to the terms and provisions of a consulting Agreement between GMXX and ICI, GMXX previously granted to ICI 1,000,000 stock options (which were subject to an S-8 registration statement filed with the Securities and Exchange Commission). In connection with the exercise of stock options, the shares of common stock of GMXX are to be issued to Pierce who has provided bona fide services to GMXX under the Consulting Agreement. Investor Communications Inc. By: /s/ Marcus Johnson January 7, 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.