FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
BELK INC [ NONE ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/28/2012 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Class A Common Stock | 12/28/2012 | J | 122,550(1) | D | $0.00 | 162,869(2) | D | |||
Class A Common Stock | 166,712(3) | I | Trustee GRAT #1 | |||||||
Class A Common Stock | 97,676(4) | I | Trustee GRAT #2 | |||||||
Class A Common Stock | 12/28/2012 | J | 26,977(5) | D | $0.00 | 1,977(6) | I | Spouse | ||
Class A Common Stock | 25,311(7) | I | Custodian | |||||||
Class A Common Stock | 141,337(8) | I | Trustee | |||||||
Class A Common Stock | 141,337(9) | I | Trustee | |||||||
Class A Common Stock | 141,337(10) | I | Trustee | |||||||
Class A Common Stock | 537,517(11) | I | Trustee | |||||||
Class A Common Stock | 12/28/2012 | J | 149,527(12) | A | $0.00 | 149,527(12) | I | Tres Casas Lodging, LLC | ||
Class A Common Stock | 1,221,842(13) | I | Brothers Investment Company | |||||||
Class A Common Stock | 444,212(14) | I | Milburn Investment Company | |||||||
Class B Common Stock | 2,696(15) | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. 122,550 shares of Class A common stock were transferred by Reporting Person to Tres Casas Lodging, LLC. |
2. 162,869 shares of Class A common stock are held in Reporting Person's name and/or H.W. McKay Belk, Trustee U/A dated 11/21/07, Reporting Person's grantor trust. |
3. 166,712 shares of Class A common stock are held by H.W. McKay Belk Grantor Retained Annuity Trust dated June 16, 2006. Reporting Person is the Trustee. |
4. 97,676 shares of Class A common stock are held by H.W. McKay Belk 2010 Grantor Retained Annuity Trust. Reporting Person is the Trustee. |
5. 26,977 shares of Class A common stock were transferred by Reporting Person's spouse to Tres Casas Lodging, LLC. |
6. 1,977 shares of Class A common stock are held by Reporting Person's spouse, Nina F. Belk. |
7. 25,311 shares of Class A common stock are held by Reporting Person as custodian of his minor children. |
8. 141,337 shares of Class A common stock are held by Katherine Whitner Belk Irrevocable Trust dated April 9, 2008. Voting and investment power is shared by Katherine Whitner Belk, Nina Ferguson Belk and H.W. McKay Belk, the Trustees. |
9. 141,337 shares of Class A common stock are held by Nina Cabell Belk Irrevocable Trust dated April 4, 2008. Voting and investment power is shared by Nina Cabell Belk, Nina Ferguson Belk and H.W. McKay Belk, the Trustees. |
10. 141,337 shares of Class A common stock are held by The Hamilton Witherspoon McKay Belk, Jr. Irrevocable Trust dated October 22, 2010. Voting and investment power is shared by H.W. McKay Belk, Jr., Nina Ferguson Belk and H.W. McKay Belk, the Trustees. |
11. 537,517 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. |
12. 149,527 shares of Class A common stock were received and are held by Tres Casas Lodging, LLC. Voting and investment power is shared by Reporting Person and Nina F. Belk, his spouse. |
13. 1,221,842 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. |
14. 444,212 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. |
15. 2,696 shares of Class B common stock are held in Reporting Person's name and/or H.W. McKay Belk, Trustee U/A dated 11/21/07, Reporting Person's grantor trust. |
Remarks: |
H.W. McKay Belk by Betty F. Buchanan, POA | 12/31/2012 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |