SEC Form 4 · accession 0001209191-15-082756
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
Nov 30, 2015
Accepted (ET)
Dec 2, 2015 · 12:25 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 | 365,720 | D | |
| Class A Common StockF6,F7 | Nov 30, 2015 | J | 407,923 | $0.00 | A | 810,207 | I | Trustee |
| Class A Common StockF3 | holding | — | — | — | 154,543 | I | Trustee GRAT #1 | |
| Class A Common StockF4 | holding | — | — | — | 146,809 | I | Trustee GRAT #3 | |
| Class A Common StockF5 | holding | — | — | — | 191,932 | I | Spouse | |
| 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 StockF11 | holding | — | — | — | 258,611 | I | Trustee | |
| Class A Common StockF12 | holding | — | — | — | 258,612 | I | Trustee | |
| Class A Common StockF13 | holding | — | — | — | 258,612 | I | Trustee | |
| Class A Common StockF14 | holding | — | — | — | 183,825 | I | Trusts, spouse and child are trustees | |
| Class A Common StockF15 | holding | — | — | — | 14,250 | I | Trustee, Family Wealth Preservation Trust | |
| Class B Common StockF16 | holding | — | — | — | 21,810 | D | ||
| Class B Common StockF17 | holding | — | — | — | 9,542 | I | Trustee | |
| Class B Common StockF18 | holding | — | — | — | 9,541 | I | Trustee | |
| Class B Common StockF19 | holding | — | — | — | 9,541 | 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.
- 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.
- F11258,611 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.
- F12258,612 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
- F13258,612 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.
- F1461,275 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.
- F1514,250 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.
- F1610,648 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.
- F179,542 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.
- F189,541 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
- F199,541 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.
- F2365,720 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.
- 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.
- F4146,809 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.
- F5191,932 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.
- F6407,923 shares of Class A common stock were received by the Trustees of Katherine McKay Belk Irrevocable Trust dated November 6, 2000, from the Grantor.
- F7810,207 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.
- 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.