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) 10/30/2014 | ||||||||||||||||||||||||||
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 | 10/30/2014 | G | 1,746(1) | D | $0.00 | 343,484(2) | D | |||
Class A Common Stock | 161,104(3) | I | Trustee GRAT #1 | |||||||
Class A Common Stock | 218,291(4) | I | Trustee GRAT #2 | |||||||
Class A Common Stock | 156,777(5) | I | Trustee GRAT #3 | |||||||
Class A Common Stock | 195,691(6) | I | Spouse | |||||||
Class A Common Stock | 484,684(7) | I | Trustee | |||||||
Class A Common Stock | 1,221,842(8) | I | Brothers Investment Company | |||||||
Class A Common Stock | 444,212(9) | I | Milburn Investment Company | |||||||
Class A Common Stock | 10/30/2014 | J | 582(10) | A | $0.00 | 189,848(11) | I | Trustee | ||
Class A Common Stock | 10/30/2014 | J | 582(12) | A | $0.00 | 189,849(13) | I | Trustee | ||
Class A Common Stock | 10/30/2014 | J | 582(14) | A | $0.00 | 189,849(15) | I | Trustee | ||
Class A Common Stock | 183,825(16) | I | Trusts, spouse and child are trustees | |||||||
Class B Common Stock | 4,755(17) | D | ||||||||
Class B Common Stock | 9,542(18) | I | Trustee | |||||||
Class B Common Stock | 9,541(19) | I | Trustee | |||||||
Class B Common Stock | 9,541(20) | I | Trustee |
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. 1,746 shares of Class A common stock were gifted by Reporting Person to his children. |
2. 343,484 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. |
3. 161,104 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. |
4. 218,291 shares of Class A common stock are held by John R. Belk Grantor Retained Annuity Trust dated October 12, 2009. Reporting Person is the Trustee. |
5. 156,777 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. |
6. 195,691 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. |
7. 484,684 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. |
8. 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. |
9. 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. |
10. 582 shares of Class A common stock were received by the trustees of the 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. |
11. 189,848 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. |
12. 582 shares of Class A common stock were received by the trustees of the 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. |
13. 189,849 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 |
14. 582 shares of Class A common stock were received by the trustees of the 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. |
15. 189,849 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. |
16. 61,275 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. |
17. 4,755 of the shares from the Belk, Inc. Executive Long Term Incentive Compensation Plan XIV are not payable to the Reporting Person until 2015. |
18. 9,542 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. |
19. 9,541 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 |
20. 9,541 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. |
Remarks: |
John R. Belk by Holly C. Williamson, POA | 10/31/2014 | |
** 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. |