SEC Form 4 · accession 0001209191-15-082752
BELK INC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Thomas M Belk Jr.
Officer — Chairman & CEO · Director · 10% Owner
Period of report
Nov 30, 2015
Accepted (ET)
Dec 2, 2015 · 12:22 pm 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 | Nov 30, 2015 | J | 5,998 | $0.00 | A | 622,909 | D | |
| Class A Common StockF11,F12 | Nov 30, 2015 | J | 407,923 | $0.00 | A | 810,207 | I | Trustee |
| Class A Common StockF3 | holding | — | — | — | 154,890 | I | Trustee GRAT #1 | |
| Class A Common StockF4 | holding | — | — | — | 142,304 | I | Trustee GRAT #2 | |
| Class A Common StockF5 | holding | — | — | — | 35,201 | I | Spouse | |
| Class A Common StockF6 | holding | — | — | — | 14,761 | I | Custodian | |
| Class A Common StockF7 | holding | — | — | — | 147,527 | I | Trustee | |
| Class A Common StockF8 | holding | — | — | — | 144,566 | I | Trustee | |
| Class A Common StockF9 | holding | — | — | — | 143,515 | I | Trustee | |
| Class A Common StockF10 | holding | — | — | — | 124,210 | I | Trustee | |
| Class A Common StockF13 | holding | — | — | — | 183,825 | I | Trusts, spouse and child are trustees | |
| Class A Common StockF14 | holding | — | — | — | 23,750 | I | Trustee, Family Wealth Preservation Trust | |
| Class A Common StockF15 | holding | — | — | — | 1,221,842 | I | Brothers Investment Company | |
| Class A Common StockF16 | holding | — | — | — | 444,212 | I | Milburn Investment Company | |
| Class A Common StockF17 | holding | — | — | — | 228,016 | I | Trustee | |
| Class B Common StockF18 | holding | — | — | — | 40,177 | D | ||
| Class B Common StockF19 | holding | — | — | — | 312 | I | Custodian | |
| Class B Common StockF20 | holding | — | — | — | 1,720 | I | Trustee | |
| Class B Common StockF21 | holding | — | — | — | 4,681 | I | Trustee | |
| Class B Common StockF22 | holding | — | — | — | 5,732 | I | Trustee | |
| Class B Common StockF23 | holding | — | — | — | 25,037 | I | Trustee |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F15,998 shares of Class A common stock were received by Reporting Person as a distribution from Katherine McKay Belk 2012 Grantor Retained Annuity Trust dated July 24, 2012.
- F10124,210 shares of Class A common stock are held by Margaret Elizabeth Belk Irrevocable Trust dated March 27, 2015. Voting and investment power is shared by Margaret Elizabeth Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F11407,923 shares of Class A common stock were received by the Trustees of Katherine McKay Belk Irrevocable Trust dated November 6, 2000, from the Grantor.
- F12810,207 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.
- F1336,765 shares of Class A common stock are held by each of the following trusts: Thomas M. Belk, Jr. & Sarah F. Belk Family Wealth Preservation Trust dated November 28, 2012, f/b/o Adelaide Lucinda Fortune Belk; Thomas M. Belk, Jr. & Sarah F. Belk Family Wealth Preservation Trust dated November 28, 2012, f/b/o Thomas Milburn Belk, III; Thomas M. Belk, Jr. & Sarah F. Belk Family Wealth Preservation Trust dated November 28, 2012, f/b/o Katherine Whitner Belk; Thomas M. Belk, Jr. & Sarah F. Belk Family Wealth Preservation Trust dated November 28, 2012, f/b/o Margaret Elizabeth Belk; and Thomas M. Belk, Jr. & Sarah F. Belk Family Wealth Preservation Trust dated November 28, 2012, f/b/o Louisa Alexandra Belk. Sarah F. Belk, Reporting Person's wife, and the child that is beneficiary of the trust are trustees of each trust.
- F1423,750 shares of Class A common stock are held by The Katherine McKay Belk FWP Trust f/b/o Thomas M. Belk, Jr. Descendants dated June 3, 2015. Reporting Person is the Trustee.
- F151,221,842 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.
- F16444,212 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.
- F17228,016 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.
- F1818,552 shares of Class B common stock are held in Reporting Person's name and/or Thomas M. Belk, Jr., Trustee U/A dated 1/18/94, Reporting Person's grantor trust. 21,625 of the shares from the Belk, Inc. Executive Long Term Incentive Compensation Plan XV are not payable to the Reporting Person until 2016.
- F19312 shares of Class B common stock are held by Reporting Person as custodian of his minor child.
- F2622,909 shares of Class A common stock are held in Reporting Person's name and/or Thomas M. Belk, Jr., Trustee U/A dated 1/18/94, Reporting Person's grantor trust.
- F201,720 shares of Class B common stock are held by Adelaide Lucinda Fortune Belk Irrevocable Trust dated August 23, 2010. Voting and investment power is shared by Adelaide Lucinda Fortune Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F214,681 shares of Class B common stock are held by Thomas M. Belk, III Irrevocable Trust dated 9-7-2010. Voting and investment power is shared by Thomas M. Belk, III, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F225,732 shares of Class B common stock are held by Katherine McKay Belk Irrevocable Trust dated August 29, 2012. Voting and investment power is shared by Katherine McKay Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F2325,037 shares of Class B common stock are held by Margaret Elizabeth Belk Irrevocable Trust dated March 27, 2015. Voting and investment power is shared by Margaret Elizabeth Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F3154,890 shares of Class A common stock are held by Thomas M. Belk, Jr., Grantor Retained Annuity Trust dated January 27, 2006. Reporting Person is the Trustee.
- F4142,304 shares of Class A common stock are held by Thomas M. Belk, Jr., Grantor Retained Annuity Trust dated 12-17-2010. Reporting Person is the Trustee.
- F535,201 shares of Class A common stock are held by Reporting Person's spouse, Sarah F. Belk and/or her grantor trust, Sarah Fortune Belk Revocable Trust dated 12-11-07.
- F614,761 shares of Class A common stock are held by Reporting Person as custodian of his minor child.
- F7147,527 shares of Class A common stock are held by Adelaide Lucinda Fortune Belk Irrevocable Trust dated August 23, 2010. Voting and investment power is shared by Adelaide Lucinda Fortune Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F8144,566 shares of Class A common stock are held by Thomas M. Belk, III Irrevocable Trust dated 9-7-2010. Voting and investment power is shared by Thomas M. Belk, III, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.
- F9143,515 shares of Class A common stock are held by Katherine McKay Belk Irrevocable Trust dated August 29, 2012. Voting and investment power is shared by Katherine McKay Belk, Thomas M. Belk, Jr. and Sarah F. Belk, the trustees.