OMB APPROVAL
OMB NUMBER 3235-0287
EXPIRES: JANUARY 31, 2005
ESTIMATED AVERAGE BURDEN
HOURS PER RESPONSE 0.5
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
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 box if no longer subject to Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
VanAlen, Jr. William L.
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(Last) (First) (Middle)
975 Derchester Road
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(Street)
Newtown Square PA 19073
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
USA Technologies USTT
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Day/Year
December, 2002
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [ ] 10% Owner
[ ] Officer (give title below) [_] Other (specify below)
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[_] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5. 6.
4. Amount of Owner-
Securities Acquired (A) or Securities ship
2A. 3. Disposed of (D) Befeficially Form: 7.
2. Deemed Transaction (Instr. 3, 4 and 5) Owned Follow- Direct Nature of
Trans- Executin Code ------------------------------- ing Reported (D) or Indirect
1. action Date, (Instr. 8) (A) Transaction(s) Indirect Beneficial
Title of Security Date if any ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (mm/dd/yy) Code V (D) and 4) (Instr.4)(Instr. 4)
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Common Stock 12/13/02 M 17,501 A 0.10 93,835 D
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Common Stock 12/31/02 A 3,000 A 0.20 93,835 D
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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
4(b)(v).
(Print or Type Response) (Over)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
Deriv- Form
2. ative of
Conver- 5. 7. Secur- Deriv- 11.
sion Number of Title and Amount ities ative Nature
or 3A. Derivative 6. of Underlying 8. Bene- Secur- of
Exer- Deemed 4. Securities Date Securities Price ficially ity: In-
cise 3. Exe- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Owned Direct direct
Price Trans- cution action or Disposed Expiration Date ---------------- Deriv- Following (D) or Bene-
1. of action Date, Code of(D) (Month/Day/Year) Amount ative Reported In- ficial
Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- Trans- direct Owner-
Derivative ative (Month/ Month/ 8) 4 and 5) Date Expira- Number ity action (I) ship
Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr.(Instr.
(Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Options 1.50 12/31/02 J(1) 10,000 07/31/93 06/30/03 Comm Stk 10,000 0 D
Options 1.50 12/31/02 J(1) 2,500 03/31/95 06/30/03 Comm Stk 2,500 0 D
Options 2.00 12/31/02 J(1) 10,000 06/17/99 06/17/04 Comm Stk 10,000 0 D
Options 1.00 12/31/02 J(1) 20,000 02/26/01 02/26/06 Comm Stk 20,000 0 D
Options 1.00 12/31/02 J(1) 15,000 06/26/01 06/26/06 Comm Stk 15,000 0 D
Options 1.00 12/31/02 J(1) 15,000 06/26/02 06/26/07 Comm Stk 15,000 0 D
Options 0.40 12/31/02 J(1) 100,000 04/12/02 04/12/05 Comm Stk 100,000 0 D
Note
Warrants 0.10 10/31/02 A 35,002 10/31/02 01/31/03 Comm Stk 35,002 17,501 D
Note Warrants 0.10 12/13/02 M 17,501 10/31/02 01/31/03 Comm Stk 17,501 $.10 17,501 D
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Explanation of Responses:
/s/ William VanAlen, Jr. January 20, 2003
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**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.