SEC Form 4 · accession 0001209191-15-072066
BELK INC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Katherine McKay Belk
10% Owner
Period of report
Sep 23, 2015
Accepted (ET)
Sep 24, 2015 · 2:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001051771
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Class A Common StockF7,F8 | Sep 23, 2015 | J | 88,197 | $0.00 | D | 109,449 | I | Custodian |
| Class A Common StockF1 | holding | — | — | — | 787,398 | D | ||
| Class A Common StockF2 | holding | — | — | — | 307,330 | I | Trustee, Charitable Remainder Unitrust | |
| Class A Common StockF3 | holding | — | — | — | 46,801 | I | Trustee, 2012 GRAT | |
| Class A Common StockF4 | holding | — | — | — | 109,874 | I | Trustee, 2013 GRAT | |
| Class A Common StockF5 | holding | — | — | — | 223,002 | I | Trustee, 2014 GRAT | |
| Class A Common StockF6 | holding | — | — | — | 120,800 | I | Trustee, 2015 GRAT | |
| Class A Common StockF9 | holding | — | — | — | 100 | I | Spouse (deceased) | |
| Class A Common StockF10 | holding | — | — | — | 1,221,842 | I | Brothers Investment Company | |
| Class A Common StockF11 | holding | — | — | — | 444,212 | I | Milburn Investment Company | |
| Class B Common StockF12 | holding | — | — | — | 24,725 | I | Custodian |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1787,398 shares of Class A common stock are held in Reporting Person's name and/or Katherine McKay Belk Trust dated November 6, 2000, Reporting Person's grantor trust. Voting and investment power of the grantor trust is shared by Katherine McKay Belk, Thomas M. Belk, Jr., H.W. McKay Belk, John R. Belk and Katherine Belk Morris.
- F101,221,842 shares of Class A common stock are held by Brothers Investment Company, which corporation is equally owned by John M. Belk QTIP GST Non-Exempt Marital Trust, Wells Fargo Bank, N.A., Susan N. Jamison and Katherine B. Morris, Co-Trustees ("John M. Belk QTIP GST Non-Exempt Marital Trust") and the heirs of Thomas M. Belk. The co-trustees of John M. Belk QTIP GST Non-Exempt Marital Trust and Katherine McKay Belk, Thomas M. Belk, Jr., H.W. McKay Belk, John R. Belk and Katherine Belk Morris, heirs of Thomas M. Belk, share voting and investment power.
- F11444,212 shares of Class A common stock are held by Milburn Investment Company. Voting and investment power is shared by Katherine McKay Belk, Thomas M. Belk, Jr., H.W. McKay Belk, John R. Belk and Katherine Belk Morris.
- F1224,725 shares of Class B common stock are held by Reporting Person as custodian of her minor grandchild.
- F2307,330 shares of Class A common stock are held by Katherine McKay Belk Cook Charitable Remainder Unitrust. Reporting Person is the Trustee.
- F346,801 shares of Class A common stock are held by Katherine McKay Belk 2012 Grantor Retained Annuity Trust dated July 24, 2012. Reporting Person is the Trustee.
- F4109,874 shares of Class A common stock are held by Katherine McKay Belk 2013 Grantor Retained Annuity Trust dated May 30, 2013. Reporting Person is the Trustee.
- F5223,002 shares of Class A common stock are held by Katherine McKay Belk 2014 Grantor Retained Annuity Trust dated April 23, 2014. Reporting Person is the Trustee.
- F6120,800 shares of Class A common stock are held by Katherine McKay Belk 2015 Grantor Retained Annuity Trust dated June 3, 2015. Reporting Person is the Trustee.
- F788,197 shares of Class A common stock were transferred to a grandchild. Reporting Person held the stock as custodian.
- F8109,449 shares of Class A common stock are held by Reporting Person as custodian of her minor grandchild.
- F9100 shares of Class A common stock are held in the name of Reporting Person's husband (deceased), James Fielder Cook.