SEC Form 4 · accession 0001209191-15-077591
BELK INC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
John R Belk
Officer — President & COO · Director · 10% Owner
Period of report
Oct 29, 2015
Accepted (ET)
Nov 2, 2015 · 10:52 am EST
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 StockF1,F2 | Oct 29, 2015 | J | 6,348 | $0.00 | A | 359,722 | D | |
| Class A Common StockF4 | Oct 29, 2015 | J | 211,389 | $0.00 | D | 0 | I | Trustee GRAT #2 |
| Class A Common StockF11,F12 | Oct 29, 2015 | J | 68,347 | $0.00 | A | 258,611 | I | Trustee |
| Class A Common StockF13,F14 | Oct 29, 2015 | J | 68,347 | $0.00 | A | 258,612 | I | Trustee |
| Class A Common StockF15,F16 | Oct 29, 2015 | J | 68,347 | $0.00 | A | 258,612 | I | Trustee |
| Class A Common StockF3 | holding | — | — | — | 154,543 | I | Trustee GRAT #1 | |
| Class A Common StockF5 | holding | — | — | — | 146,809 | I | Trustee GRAT #3 | |
| Class A Common StockF6 | holding | — | — | — | 191,932 | I | Spouse | |
| Class A Common StockF7 | holding | — | — | — | 402,284 | I | Trustee | |
| Class A Common StockF8 | holding | — | — | — | 1,221,842 | I | Brothers Investment Company | |
| Class A Common StockF9 | holding | — | — | — | 444,212 | I | Milburn Investment Company | |
| Class A Common StockF10 | holding | — | — | — | 228,016 | I | Trustee | |
| Class A Common StockF17 | holding | — | — | — | 183,825 | I | Trusts, spouse and child are trustees | |
| Class A Common StockF18 | holding | — | — | — | 14,250 | I | Trustee, Family Wealth Preservation Trust | |
| Class B Common StockF19 | holding | — | — | — | 21,810 | D | ||
| Class B Common StockF20 | holding | — | — | — | 9,542 | I | Trustee | |
| Class B Common StockF21 | holding | — | — | — | 9,541 | I | Trustee | |
| Class B Common StockF22 | holding | — | — | — | 9,541 | I | Trustee |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F16,348 shares of Class A common stock were received by Reporting Person from John R. Belk Grantor Retained Annuity Trust dated October 12, 2009.
- F10228,016 Class A shares held in a trust established by the Will of W.H. Belk for the benefit of Thomas M. Belk. Sarah Belk Gambrell, Katherine Belk Morris, Thomas M. Belk, Jr., H.W. McKay Belk and John R. Belk, the trustees, share voting and investment power.
- F1168,347 shares Class A common stock were received by the trustees of the Anna Dupree Belk Irrevocable Trust dated May 28, 2010 as a transfer from Anna Dupree Belk who received the shares as a distribution from John R. Belk Grantor Retained Annuity Trust dated October 12, 2009. Reporting Person is a trustee of this trust.
- F12258,611 shares of Class A common stock are held by Anna Dupree Belk Irrevocable Trust dated May 28, 2010. Voting and investment power is shared by Anna Dupree Belk, John R. Belk and Kimberly D. Belk, the trustees.
- F1368,347 shares Class A common stock were received by the trustees of the John Robert Belk, Jr. Irrevocable Trust dated August 11, 2011 as a transfer from John Robert Belk, Jr. who received the shares as a distribution from John R. Belk Grantor Retained Annuity Trust dated October 12, 2009. Reporting Person is a trustee of this trust.
- F14258,612 shares of Class A common stock are held by John Robert Belk, Jr. Irrevocable Trust dated August 11, 2011. Voting and investment power is shared by John Robert Belk, Jr., John R. Belk and Kimberly D. Belk, the trustees
- F1568,347 shares Class A common stock were received by the trustees of the Frances Whitner Belk Irrevocable Trust dated August 18, 2014 as a transfer from Frances Whitner Belk who received the shares as a distribution from John R. Belk Grantor Retained Annuity Trust dated October 12, 2009. Reporting Person is a trustee of this trust.
- F16258,612 shares of Class A common stock are held by Frances Whitner Belk Irrevocable Trust dated August 18, 2014. Voting and investment power is shared by Frances Whitner Belk, John R. Belk and Kimberly D. Belk, the trustees.
- F1761,275 shares of Class A common stock are held by each of the following trusts: John R. Belk & Kimberly D. Belk Family Wealth Preservation Trust dated December 21, 2012, f/b/o Anna Dupree Belk; John R. Belk & Kimberly D. Belk Family Wealth Preservation Trust dated December 21, 2012, f/b/o John Robert Belk, Jr.; and John R. Belk & Kimberly D. Belk Family Wealth Preservation Trust dated December 21, 2012, f/b/o Frances Whitner Belk. Kimberly D. Belk, Reporting Person's wife, and the child that is beneficiary of the trust are trustees of each trust.
- F1814,250 shares of Class A common stock are held by The Katherine McKay Belk FWP Trust f/b/o John R. Belk Descendants dated June 3, 2015. Reporting Person is the Trustee.
- F1910,648 shares of Class B common stock are held in Reporting Person's name and/or John Robert Belk, Trustee U/A dated 1/17/94, Reporting Person's grantor trust. 11,162 of the shares from the Belk, Inc. Executive Long Term Incentive Compensation Plan XV are not payable to the Reporting Person until 2016.
- F2359,722 shares of Class A common stock are held in Reporting Person's name and/or John Robert Belk, Trustee U/A dated 1/17/94, Reporting Person's grantor trust.
- F209,542 shares of Class B common stock are held by Anna Dupree Belk Irrevocable Trust dated May 28, 2010. Voting and investment power is shared by Anna Dupree Belk, John R. Belk and Kimberly D. Belk, the trustees.
- F219,541 shares of Class B common stock are held by John Robert Belk, Jr. Irrevocable Trust dated August 11, 2011. Voting and investment power is shared by John Robert Belk, Jr., John R. Belk and Kimberly D. Belk, the trustees
- F229,541 shares of Class B common stock are held by Frances Whitner Belk Irrevocable Trust dated August 18, 2014. Voting and investment power is shared by Frances Whitner Belk, John R. Belk and Kimberly D. Belk, the trustees.
- F3154,543 shares of Class A common stock are held by John R. Belk Grantor Retained Annuity Trust dated January 23, 2006. Reporting Person is the Trustee.
- F4211,389 shares of Class A common stock were distributed by John R. Belk Grantor Retained Annuity Trust dated October 12, 2009 as the final distribution. 6,348 shares of Class A common stock were distributed to the Grantor, and 205,041 shares of Class A common stock were distributed to the beneficiaries. Reporting Person is the Trustee.
- F5146,809 shares of Class A common stock are held by John R. Belk Grantor Retained Annuity Trust dated October 22, 2010. Reporting Person is the Trustee.
- F6191,932 shares of Class A common stock are held by Kimberly D. Belk, Reporting Person's spouse, or by her grantor trust, Kimberly Dupree Belk Revocable Trust dated July 27, 2007.
- F7402,284 shares of Class A common stock are held by Katherine McKay Belk Irrevocable Trust dated November 6, 2000. 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.
- F81,221,842 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.
- F9444,212 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.