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) 11/30/2015 | ||||||||||||||||||||||||||
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 | 11/30/2015 | J | 5,998(1) | A | $0.00 | 629,166(2) | D | |||
Class A Common Stock | 319,130(3) | I | Trustee GRAT dtd 9/8/04 | |||||||
Class A Common Stock | 24,281(4) | I | Trustee GRAT #3 dtd 8/30/10 | |||||||
Class A Common Stock | 26,581(5) | I | Trustee GRAT #4 dtd 8/30/10 | |||||||
Class A Common Stock | 28,294(6) | I | Trustee GRAT #5 dtd 8/30/10 | |||||||
Class A Common Stock | 125,144(7) | I | Trustee GRAT #1 dtd 11/30/11 | |||||||
Class A Common Stock | 28,829(8) | I | Irrevocable Trust dtd 8/10/04 | |||||||
Class A Common Stock | 36,712(9) | I | Spouse | |||||||
Class A Common Stock | 11/30/2015 | J | 95,867(10) | D | $0.00 | 95,867(11) | I | Trustee | ||
Class A Common Stock | 188,791(12) | I | Trustee | |||||||
Class A Common Stock | 193,204(13) | I | Trustee | |||||||
Class A Common Stock | 11/30/2015 | J | 407,923(14) | A | $0.00 | 810,207(15) | I | Trustee | ||
Class A Common Stock | 256,095(16) | I | Trusts, spouse and child are trustees | |||||||
Class A Common Stock | 14,250(17) | I | Trustee, Family Wealth Preservation Trust | |||||||
Class A Common Stock | 444,212(18) | I | Milburn Investment Company | |||||||
Class A Common Stock | 1,221,842(19) | I | Brothers Investment Company | |||||||
Class A Common Stock | 228,016(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. 5,998 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. |
2. 629,166 shares of Class A common stock are held in Reporting Person's name and/or Katherine Whitner McKay Belk Morris, Trustee U/A dated December 28, 1993, Reporting Person's grantor trust. |
3. 319,130 shares of Class A common stock are held by Katherine B. Morris Grantor Retained Annuity Trust dated September 8, 2004. Reporting Person is the Trustee. |
4. 24,281 shares of Class A common stock are held Katherine Belk Morris 2010 Grantor Retained Annuity Trust Number Three dated August 30, 2010. Reporting Person is the Trustee. |
5. 26,581 shares of Class A common stock are held Katherine Belk Morris 2010 Grantor Retained Annuity Trust Number Four dated August 30, 2010. Reporting Person is the Trustee. |
6. 28,294 shares of Class A common stock are held Katherine Belk Morris 2010 Grantor Retained Annuity Trust Number Five dated August 30, 2010. Reporting Person is the Trustee. |
7. 125,144 shares of Class A common stock are held by Katherine Belk Morris 2011 Grantor Retained Annuity Trust Number One dated Nov. 30, 2011. Reporting Person is the Trustee. |
8. 28,829 shares of Class A common stock are held by Katherine W. M. B. Morris Irrevocable Trust dated 8/10/2004. Voting and investment power is held by Charles Walker Morris, spouse, and Lewis S. Morris, III, Co-Trustees. |
9. 36,712 shares of Class A common stock are held by Reporting Person's spouse, Charles Walker Morris and/or Charles Walker Morris Revocable Trust dated September 8, 2004, his grantor trust. |
10. 95,867 shares of Class A common stock were distributed to Miss Katherine Belk Morris, the Grantor, by the Trustees of Miss Katherine Belk Morris Irrevocable Trust dated January 10, 2003. |
11. 95,867 shares of Class A common stock are held by Miss Katherine Belk Morris Irrevocable Trust dated January 10, 2003. Voting and investment power is vested in Miss Katherine Belk Morris, Katherine Belk Morris and Charles Walker Morris, the Trustees. |
12. 188,791 shares are Class A common stock are held by Charles Walker Morris, Jr. Irrevocable Trust dated May 25, 2005. Voting and investment power is vested in Charles Walker Morris, Jr., Katherine Belk Morris and Charles Walker Morris, the Trustees. |
13. 193,204 shares of Class A common stock are held by Rebecca Price Morris Irrevocable Trust dated January 6, 2009. Voting and investment power is vested in Rebecca Price Morris, Katherine Belk Morris and Charles Walker Morris, the Trustees. |
14. 407,923 shares of Class A common stock were received by the Trustees of Katherine McKay Belk Trust dated November 6, 2000, from the Grantor. |
15. 810,207 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, the Trustees. |
16. 85,365 shares of Class A common stock are held by each of the following trusts: Katherine Belk Morris Family Wealth Preservation Trust dated December 21, 2012, f/b/o Katherine Morris Stanley; Katherine Belk Morris Family Wealth Preservation Trust dated December 21, 2012, f/b/o Charles Walker Morris, Jr.; and Katherine Belk Morris Family Wealth Preservation Trust dated December 21, 2012, f/b/o Rebecca Price Morris. Charles Walker Morris, Reporting Person's husband, and the child that is beneficiary of the trust are trustees of each trust. |
17. 14,250 shares of Class A common stock are held by The Katherine McKay Belk FWP Trust f/b/o Katherine Belk Morris Descendants dated June 3, 2015. Reporting Person is the Trustee. |
18. 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. |
19. 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. |
20. 228,016 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. |
Remarks: |
Katherine Belk Morris by Holly C. Williamson, POA | 12/02/2015 | |
** 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. |