SEC Form 4 · accession 0001209191-15-084975

BELK INC

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Katherine Belk Morris

10% Owner

Period of report

Dec 10, 2015

Accepted (ET)

Dec 14, 2015 · 3:41 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	D/I	Nature of ownership
Class A Common Stock^F1	Dec 10, 2015	J	629,166	—	D	D
Class A Common Stock^F1	Dec 10, 2015	J	319,130	—	D	I	Trust GRAT dtd 9/8/04
Class A Common Stock^F1	Dec 10, 2015	J	24,281	—	D	I	Trust GRAT #3 dtd 8/30/10
Class A Common Stock^F1	Dec 10, 2015	J	26,581	—	D	I	Trust GRAT #4 dtd 8/30/10
Class A Common Stock^F1	Dec 10, 2015	J	28,294	—	D	I	Trust GRAT #5 dtd 8/30/10
Class A Common Stock^F1	Dec 10, 2015	J	125,144	—	D	I	Trust GRAT #1 dtd 11/30/11
Class A Common Stock^F1,F2	Dec 10, 2015	J	28,829	—	D	I	By Trust
Class A Common Stock^F1,F3	Dec 10, 2015	J	95,867	—	D	I	By Trust
Class A Common Stock^F1,F3	Dec 10, 2015	J	188,791	—	D	I	By Trust
Class A Common Stock^F1,F3	Dec 10, 2015	J	193,204	—	D	I	By Trust
Class A Common Stock^F1,F3	Dec 10, 2015	J	810,207	—	D	I	By Trust
Class A Common Stock^F1,F2	Dec 10, 2015	J	256,095	—	D	I	By Trust, spouse and child are trustees
Class A Common Stock^F1,F3	Dec 10, 2015	J	14,250	—	D	I	By Trust, Family Wealth Preservation Trust
Class A Common Stock^F1,F4	Dec 10, 2015	J	444,212	—	D	I	Milburn Investment Company
Class A Common Stock^F1,F4	Dec 10, 2015	J	1,221,842	—	D	I	Brothers Investment Company
Class A Common Stock^F1,F3	Dec 10, 2015	J	228,016	—	D	I	By Trust
Class A Common Stock^F1	Dec 10, 2015	J	36,712	—	D	I	By Spouse

Table II — derivative securities

No Table II lines on this filing.

Explanation of responses

F1An Agreement and Plan of Merger, dated as of August 23, 2015 (the "Merger agreement"), was entered by and among Bear Parent Inc. ("Parent"), Bear Merger Sub Inc. ("Merger Sub") and Belk, Inc. (the "Company"), under which Merger Sub was merged with and into the Company, with the Company surviving the merger (the "Merger"). Upon consummation of the Merger on December 10, 2015, each share of the Company's Class A common stock and Class B common stock outstanding immediately prior to the Merger (other than certain shares as set forth in the Merger Agreement) was converted automatically into $68.00 in cash. After the Merger was completed, the Company became a wholly-owned subsidiary of Parent, an affiliate of investment funds managed by Sycamore Partners Management, L.P. The Merger is more completely described in the Company's Definitive Proxy Statement filed with the SEC on October 2, 2015.
F2Shares were held in a trust in which members of the Reporting Person's immediate family is one or more of the trustees. Reporting Person disclaims beneficial ownership in shares in which he did not have a pecuniary interest.
F3Shares were held in a trust in which Reporting Person was one of the trustees. Reporting Person disclaims beneficial ownership in shares in which he did not have a pecuniary interest.
F4Shares were held in a family owned company in which the Reporting Person shares voting and investment control. Reporting Person disclaims beneficial ownership in shares in which he did not have a pecuniary interest.