Agnes Rankin Beane

STATE ETHICS COMMISSION Date Received: 78 il i; J) 2023 STATEMENT OF ECONOMIC INTEREST E No Change Form This entire form must be completed to fulfill your SEI filing obligation. Lona | Bere |] Reason for Filing (Complete all that apply.) State Government Job (Spey agency and positon.) | Board/Commission (Ust the complete names of all State. boards on which you are serving or are being considered.) LL Tunew ba Tse ‘Currently Serving or Served as a Judicial Office in 2022 | Currently Serving or Served a5 a Legiiator in 2022 (Speci (Specify office, e.. Judge, clerk of cour, district attorney.) House of Senate.) “AFFIRMATION 1 have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue to be true, correct, and complete to the best of my knowledge and belle. 1 have not transferred, and will na transfer, any asset, interest, or property for the purpose of concealing it from disclosure whi retaining an equitable Interest. Tunderstand that my No Change Form is a public record. Ihave read and understand the following statutes: N.C.GS. § 1384-26. Concealing o filing to sclose material information. A fling person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guity of a Clas 1 misdemeanor and ...- subject 0 disciplinary action under G.5. 1384.45. N.C.G.S. § 1384-27. Penalty for false information. Afiing person who provides fase information on a statement of economic terest. . . knowing tht the information is fase s uly of a Class Hi felony and shal be subject t disciplinary action under G.5. 1364-45. T affirm under penalty of perjury that the foregoing is true and correct. Agnes 0. bane t/u/23 Signature Date Aves ¢. best Printed Name Submit signed, original documents only. Do not fax or e-mal this form. This document is a public record.

FORSTAFFUSEONLY Gr STATE ETHICS COMMISSION Date Received: ir 2022 STATEMENT OF ECONOMIC INTEREST RECEIVED No Change Form | wrisan This entire form must be completed to fulfill | your SEI filing obligation. NC ETHICS COMMISSION [oven | Festame | adorns | tame | sumn_| mg | Annes | ® | Gee |] Reason for Filing (Complete all that apply) State Government Job (Speciy agency and position) | Board/Commission (Lst the complete names of ll State boards on which you are serving or are being considered.) [ [une-w BdofTwibes: Currently Serving as a Judicial Officer (Spec office.) __| Currently Serving 05 3 Legislator (Specify House or Senate.) “Are you a CANDIDATE for 2 covered elected office? | | If Yes, specify office and District County I, applicable: (District, Superior, or Supreme Court, Court of Clerk of Court, District Attorney, General Assembly) [Yes [JNo AFFIRMATION 1 have carefully reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue. to be true, correct, and complete to the best of my knowledge and belief. 1 have not transferred, and wil not transfer, any asset, interest, or property for the purpose of concealing it from Giscosure while retaining an equitable interest. {understand that my No Change Form is a public record. have read and understand the folowing statutes: N.C.G.5. § 1384-26, Concealing or fang to disclose material information. A filng person who knowingly conceals or knowingly fait to disclose information tha i required to be disclosed ona Sarement of economic Interest. . - hall be Quilty of a Class 1 misdemeanor and . . subject to dsipinary action under G.S. 1364-45. N.C.G.5. § 1384-27. Penalty for flse information. A fing person who provides false information on a statement of economic Interest... Knowing that the Information i fose 3 Quy of a Cass H felony and shal be subject to disciplinary action under G.5. 1384-45. I afirm under penalty of perjury that the foregoing is true and correct. Aa wes 4. bone 4 R22 Signature Date Agnes Besne Printed Name ‘Submit signed, original documents only. Do not fax or e-mal this form. This document Is a public record

CE — ER STATE ETHICS COMMISSION HA 2 J 2021 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM li RECEIVED This entire form must be completed to fulfill I. your SEI filing obligation. MAR 2 9 2001 | Ne iC ETHICS COMM! ISSION [Filers Name (Fist, Middle, Lost) — I Prefix First Name _ Middle Name Last Name Suffix | mvs | Agnes Louniin Beane | Reason fo fing (Complete ai mat 3077) [Stee Government 1ob (spect agency and postion.) | Board Commission (Lt te compete names of 1 Sate UNC-w Goavd oF Tuustecs [osc oer (spec ofce) egiotor (pesty rose or Sense) | 7 1 A — I — | nave careuly review my most recently fed Statement f Economic Interest Long Form and my responses continue | 9 be true, correct, and comple 6 he bes of my knowiedge an pee 1 have not transferred, and wil ot transer, any asset, intrest, o property fo the purpose of concealing it from Gslosurs whi Tevaning an cqurabie Ieres. understand that my No Change Form i a publ record. 1 have read and understand th following statutes: NC.G.S. § 1384-25. Conceaing or fing to disclose materal information A fling person who knowingly conceats or knowingly fist disclose information that s require o be disclosed n'a statement of ccanomic eres shall 5G Quy of 5 Clash 1 isdamcanor and. subject 6 iscplmer 2Cton under 6.5. 3speas. NC.G.5. 5 138427. Penalty for fase information 1 Information fase 2 guy of 3 Clos H felony and 3hll be Sublet fo cipro acon under G5. 1364 45, | Xaffiem under penaity of perjury that the foregoing is true and correct. A Gres R. forsns 2.9220 | Signature Be A res L- Brant Printed Name Submit signed, original documents only. Do not fax or e-mail this form. . I This entire document is a public record.

GN STATE ETHICS COMMISSIO oe eB OE (8h) N "HECEIVED KA2278 2020 STATEMENT OF ECONOMIC INT & al 7] EREST " CY) NO CHANGE FORM vgn This entire form must be completed to fulfill NC ETHICS COMMISSION your SEI filing obligation. a for completion Samed ome enereainos by [prox [| risthame | wiadteMame | tasthame [sux | Aanss Rankin _| Beane T_ cason for Filing (Complete oll that app) * Sate Goverment Job (Spel 79ency ond postion.) | Board/Cammission (st the complete names of al State earch on which you ar serving or ae being considered.) 1] unes BA oF Tistees - Sudical Officer (Specty office) Tegiator (Specty House or Senate) — _ - = have carefully reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue ere comec, nd complet to th best of my knowledge and belle. hove not transferred, and will ot transfer, any asset, terest, o property forthe purpose of concealing I from sclosore while retaining an equitable Interest understand that my No Change Form s 2 public record. 1 have read and understand the following statutes: | N.C.G.S. § 138A-26. Concealing or falling to disclose material information. A ing person who knowingly conceals or knowingly falls t disclose information that s required to be disclosed erent of ekonomic teres . shal be aulty of a lass 1 misdemeanor and... Subject to disciplinary Sion under 6.5. 158-45. N.C.G5. § 1384.27. Penalty fr false information. A ling person who provides fase information on a statement of economic intrest... knowing that the Be os uty of 5 Clas H felony and shal be subject t disciplinary action under G.5. 1364-45. 1 affirm under penalty of perjury that the foregoing is true and correct. Aimer Rake Shtfeo Er iltfe A, fret R. Pane Printed ame Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a pubic record.

on von sare use or CE VED 6 AY STATE ETHICS COMMISSION Date Recemed: 11 4501 [AoE wari40 RE "7 2019 STATEMENT OF ECONOMIC INTEREST == - ETHICS GRMMISSION && NO-CHANGE FORM ceca or NSTHICS GR! This entire form must be completed to fulfill your scanned do one srt] “ ethics filing obligation. Nei Fller’s Name (Firs, Middle, Last) Prof | FirstName | middieName | LastName [| sumx | me | Agra | tah [fences [| Reason for Filing (Complete all that apply. ‘State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State boards on which you are serving o are being considered. UNCW Boor ot TvusTeed Judicial Officer (Specify office.) Legishator (Specify House or Senate.) | AFFIRMATION “The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate to the best of my knowledge and belief I have not transferred, and wil not transfer, any asset interest, or property forthe purpose of concealing it from disclosure Whi retaining an equitable interest. 1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding Unemancipated Children public records. 1 have read and understand the following statutes: N.C.G.5. § 163A 191. Concealing or failing to disclose meri! information. A fing person who knowingly conceals or knowingly fals to disclose information that is required to be disclosed on 2 statement of economic nterest shall be gui of a Class 1 misdemeanor and ... subject to disciplinary action Under GS. 163A415. N.C.G.5. § 163-192. Penalty for flse information. A fling person who provides false information on a statement of economic Interest . . . knowing that the information is false 5 guilty of a Class H felony and shall be subject to disciplinary action under G.5. 163A-415. 1 affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and belief. Latfirm under penalty of perjury that the foregoing is true and correct. Panre L- Bent 5-10-2019 Signature ra— Agnes R. Begum | Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

RECENT" = Ton STAFF USE OWLY 5707 Go STATE ETHICS COMMISSION FoR STAFF USE OMY JAN 2 © 7 (Rie Stal 70) MMI Ur Q cl #/J) 2019 STATEMENT OF ECONOMIC INTEREST STATE ETHICS CONN! 7 NO-CHANGE FORM checked or completion 5\S This entire form must be completed to ful your [sown 515 owet 24111 ethics filing obligation. Rota [prefix | irstiame | wddiename | Last Name [sore | nes | Fgnos | Ranke ene [| Soares on which you ar serving o re bing considered UNC W- Boadt A Trustees Judicial Officer (Specify office.) Legislator (Spey House or Senate.) mer { The information provided n this Statement of Economic Interest and ny attachments are rue, complete, and accurate to the best of my knowiedge and beer. | a torts anit tr, 5s, rst repr foe es of ace fom dsc | While retaining an equitable intrest understand that my Statement of Economic Interest and any attachments except fo the Confidential Form Regarding Unemancipated Chidren publ records. have read and understand the following statues: N.CG.5. § 1634-191. Conceaing or falling to disclose materil information A filng person who knowingly conceals or knowingly fais to disclose information that s required to be disclosed on 2 tment of economic nero shall be Qulty of a las 1 misdemeanor and . subject o iscipinary action Unter G5. 16A415. N.CG.5. § 1634192. Penaty for false information A fling person who provides ase information on a statement of economic interes knowing hat the information | 15 Tlod uty of a Class felony and shal be subject to disciplinary acon under G.5. 163A-415. | 1 affiem that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of | December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and beiet. affirm under penalty of perjury that the foregoing is true and correct. Apes a buss 1/24/2014 | Snare no, Ba Agnes o. Bune Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a public record.

= iT TT lc {i}; NORTH CAROLINA STATE BOARD OF FOR COTIPAIRIR UF 158 ik #4 ELECTIONS AND ETHICS ENFORCEMENT |outc hecenes 2018 STATEMENT OF ECONOMIC INTERESTA!} FEB 13 pi 4: gg NO CHANGE FORM E scares owe THIS ENTIRE FORM MUST BE COMPLETED TO | © FULFILL YOUR ETHICS FILING OBLIGATION — [Few wav (rear, moore, sry : - — prefix | firstname Middle Nama Last Name. Suffix ms | Agnes Raniin | Bepinc. i i | REASON FOR FILING (COMPLETE ALL THAT APPLY) _ — | STATE GOVERNMENT 108 (Spec Agency and Postion) | BOARD/COMMISSION (Lt the comple rare of al State | N 1” boards on which you are serving or are being considers) | — 1 WNC W Bd Trsites JUDICIAL OFFICER (Specty Office) LEGISLATOR (Speciy House or Senate) 1] I | SS J | AFFIRMATION ffm that te information provided in this Statement of Economic Interest and any attachments hereto are ue, | omic, and aceurats 1 toe bet of roy knows 3nd bel. i | 1aiso certify that 1 have not transferred, and will not transfer, any asset, interest, or property for the purpose of | concesing rom discisurs whe eto an tobe mere. understand that my Statement of Economic Interest and any sttachments or supplements heres (with the exception of ee 1 acknonedae that have read and understand .C.G.5. 1388-26 regarding concealing or failing to disclose material | lmao ns 5 135 7 ars row oe fron § 1384-26. Conceaiing or fing to close mater formation || A fing person who knowingy conceats or knowinly fais to disclose information that equ to be discsed n'a Statement of economic mires: under his Ace shal be gun of a Class | medemepnor and onli be | Subject Lo inci inary action onder G.5. 138A. 5 1358.27. Penalty for false information | A fling person who provides fase formation cn 3 statement of sconarmi interest s recur under hs Ace ng aT GT oe Go 3 Cts 00 44 Sn 8 Se Susy rn | GS Tass. Pane Brae 2-0-2018 Swe, Gwe Agnes 0 bean | ae | Submit SIGNED, ORIGINAL documents only. Do not ax or e-mail this form. This entice document is pubic record.

NORTH CAROLINA STATE ETHICS COMMISSION fro: orice comin occ ny oe rc | 4 2017 STATEMENT OF ECONOMIC INTEREST « | - NO CHANGE FORM checks or comptnon 2 THIS ENTIRE FORM MUST BE COMPLETED TO. |scpnes one FULFILL YOUR ETHICS FILING OBLIGATION cores oan, | FILER'S NAME (FIRST, MIDDLE, LAST) - Prefix | First Name Widdie Name Last Name Suttic REASON FOK FILING (COMPLETE ALL THAT APPLY) - evant ot apt oer amt ee) RSET re ome metas | rds an whieh you are serving o are beng congared JUDICIAL OFFICER (spect Office) LEGISLATOR (Specty Howse or Senate) | aewATON —— a en information provides this Statement. of Economic Interest an any attachments hereto are tre, Compre, and accurate t te bac of my knawiedse and betel ats certity thot 1 have not transferred, and wil not ansfe, any asst, interest, or property for the purpose of concealing Tom Sicoooe whi recaning an equiab Mares: understand hat my Statement of Economic Interest and any attachments or supplements thereto (ith the exception of Ine Contigo Fort regan Unemancipated Chen) are Buble 1ecos acknowledge that 1 have ead and understand N.C.G.5. 135A-26 regarding conceding or fling to disclose materia tormetion and 1.C.G.5 15637 egarng provking flse nlormation 5 1368.26. Concealin or fling to disclose maternal formation. Ming person who knowingly concess or knowingly fais t disclose information tha s required 0 be disclosed on era tana where eer tn Acie shall be Quy of 3 Claes. 1 miemcaner and shall be subject to Scpmory acon under 6.5. 139-45 5 138A-27. Penaty for fis formation. A fling person who provides fase information on a statement of economic intrest s required under this Ace ra to vio lo 5 uly of Cin. ony and shall be subject iscipinary action under rage I haraby affirm that 1 have reviewed my most recently fied 2016 Statement of Economic Interest and that ss Ee ve mo responses continue to be th, correct, and complete to the best of my knowledge 2nd beret. 1 Raree Py fej: Zoe wed Err = Bate foipncy bo fruowis Feit. This entire document is 2 public record.

Pa NORTH CAROLINA STATE ETHICS COMMISSION ermine KB | Boe Rec J 2017 STATEMENT OF ECONOMIC INTEREST 7" oe 338 NO CHANGE FORM Checked for completion Bet. THIS ENTIRE FORM MUST BE COMPLETED TO |cconres one FULFILL YOUR ETHICS FILING OBLIGATION ered in 08 1] vy Bet [Fens wave (riksy, woowe, sry Prefix First Name Middle tame | Last Name. surtix Tee | Aan oo Beane a. mes | Agnes | £- | Benen 00000 | REASON FOR FILING (COMPLETE ALLTHAT APPLY) oo STATE GOVERNMENT JOB (Spey Agency and Fosion) | BOARO/COMMISSION (Ut th complete name af i tte | boards on which you are serving or are being considered) | anews Bd of- Trustees SUDICIAL OFFICER (Speci Office) | LEGISLATOR (Spec House or Senate) A SE FE AFFIRMATION | fi th th information provided i tis Statement of Economic interes and any attochments hereto are true, | Complete, 3nd accurate t the best of my knowledge and belie | {also certity that 1 have not transferred, and vil not transfer, any asset, interest, or property for the purpose of concealing | Krom closure whi etsning an cqtable meres, ne Contental Forth regarding Unermanapated Chidren) oe Ube record 1 1 acknowledge that 1 have read and understand N C.G.S. 138A-26 regarding concealing of ailing to disclose material | Infomation nd N.C.G.5. 138427 regarding providing folse formation: | 5 1384-26. Concening or ailing to disclose materia information. | A fling person who knowingly conceals or knowingly fais to close information tha 1 required o be disclosed on | 3 oimarment of aConomic eres under hs Ar shal be ity of a Cass 1 misdemeanor and shall be subject to pbnary action under G.5. 1384.45 | § 138A-27. Penalty for false information. [1 nowing tha tn nfrmaton To 1 Guy of 8 Coos H any and shall oe Subec to Gscpnay acon under | Esmis | | ray tte hn 3 ce ovine sy mat cantly ed 2016 Stems of Fano rest an hn as | Ei EEE ang atiat. No hgree | Aaues a. eos Ld | Signature. Date i Agnes bane I Printed Name. N ‘Submit SIGNED, ORIGINAL documents anly. Do no fax or e-mail this form. This entire document is 2 public record.

oo. Sm Se Snoop ETHICS COMMISSION USE ONLY hy ote Reeve: 4 2016 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM Be cress ompron BC THIS ENTIRE FORM MUST BE COMPLETED TO |scaniec bate FULFILL YOUR SEI FILING OBLIGATION Entered in 083] 0 vy AC FILER'S NAME (FIRST, MIDDLE, LAST) oo EE | Prefix | FirstName | middie Name | Last Name sume | we | Agnes | Renin [Beane | REASON FOR FILING (SELECT ALL THAT APPLY) [CJ STATE GOVERNMENT JOB (Please speciy the agency for | (] BOARD/COMMISSION (Please lst complete name of al which you work or are being considered) ‘State boards on which you are serving or are being. — consderesy UNC bd ot Trustees [JUDICIAL OFFICER (Please specify the ofice you hold) | [J LEGISLATOR (Please specify House or Senate) AFFIRMATION Taf that the information provided in this Statement of Economic Interest and any attachments hereto are true, Complete, and accurate to the best of my Knowledge and bell 1 also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing from disclosure while retaining an equitable interes. | 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Children) are public record. | 1 acknowledge that 1 have read and understand N.C.G.5. 138-26 regarding concealing o falling to disclose: material | Information and N.C.G.5. 138A-27 regarding providing aise information: { 5 138A.26. Concealing or ailing to disclose material information ! A in person who krawingly conceals or snwinly fll t disclose formato that required 0 bs disclosed an | a sttermen of Genomic erst Under fs Ave 3a 2 ly of 0 Cas 1 misdemeanor ana shi be sito | Siscipinary action under G.5. 1364-45. 5 138A-27. Penalty for false information A fling person who provides false information on 3 statement of eccnomic interest as required under this Article Knowing that the information s aise 15 Quilty of a Class H felony and shal be subject o disciplinary action under 65. 1388.45 I hereby affirm that I have reviewed my most recently filed 2015 Statement of Economic Interest and that as of Deceiber 33, 015, my responses continue o be tue, correc, and complete othe bet of my knowledge and belief. 71 Agree . Aopen &. bbve 2.49 20 | Signature TT Date | Pons 2 Beant | Printed Name | ‘Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. —

COMPLETE THIS FORM AND MAIL SIGNED, ORIGINAL TO STATE ETHICS COMMISSION, 1324 MAIL SERVICE CENTER, RALEIGH, NC 27699-1324 NORTH CAROLINA STATE ETHICS COMMISSION 2015 STATEMENT OF ECONOMIC INTEREST 919-715-2071 www.ethicscommission.nc.gov FILER'S NAME (FIRST, MIDDLE, LAST) First Name Middle Name Last Name Suffix agnes rankin beane CURRENT EMPLOYER JOB TITLE retired n/a NATURE OR TYPE OF BUSINESS n/a REASON FOR FILING (SELECT ALL THAT APPLY) STATE GOVERNMENT JOB (Please specify the agency for which you work or are being considered) BOARD/COMMISSION (Please list complete name of all State boards on which you are serving or are being considered) UNC Wilmington Trustees; JUDICIAL OFFICER (Please specify the office you hold) LEGISLATOR (Please specify House or Senate) The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 12 Do other immediate family members reside in your household? Yes No When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also includes members of your extended family (your and your spouse’s children, grandchildren, parents, grandparents, and siblings, and the spouses of each of those persons) who reside in your household. Minors are emancipated by marriage, enlistment in the US military, or court action for emancipation. FULL NAME OF ADULTS & EMANCIPATED MINORS RELATIONSHIP EMPLOYER JOB TITLE NATURE OF BUSINESS INITIALS FOR UNEMANCIPATED CHILDREN RELATIONSHIP EMPLOYER JOB TITLE NATURE OF BUSINESS PROPERTY INTERESTS 1. As of December 31, 2014, did you, your spouse, or members of your immediate family: A. Have an ownership interest in North Carolina real estate (including your residence) with a market value of $10,000 or more? Yes No Owner of Real Estate % Ownership Interest Location by City Location by County B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of $10,000 or more? Yes No Name of Lessor Name of Lessee (Renter) If Real Estate, Location by City & County If Personal Property, Describe The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 12 2. At any time during 2013 or 2014 , did you, your spouse, or members of your immediate family sell to or buy from the State of North Carolina personal property with a market value of $10,000 or more? Yes No Name of Purchaser Name of Seller Type of Property FINANCIAL INTERESTS 3. As of December 31, 2014, did you, your spouse, or members of your immediate family own any of the following financial interests valued at $10,000 or more? A. Stock in a publicly owned company? Yes No Do not list ownership interests in a widely held investment fund (including mutual funds, regulated investment companies, or pension or deferred compensation plans) if: (i) the fund is publicly traded or its assets are widely diversified; and (ii) neither you nor an immediate family member are able to control the assets held in the mutual fund, investment company, or pension or deferred compensation plan. Owner of Interest Full Name of Company (Do not use a ticker symbol) See Attached B. Stock Options in a company or business? Yes No Owner of Stock Option Full Name of Company (Do not use a ticker symbol) C. Interests in a non-publicly owned company or business entity (including interests in sole proprietorships, partnerships, limited partnerships, joint ventures, limited liability companies, limited liability partnerships, and closely held corporations)? Yes No If "No", proceed to question 4. Owner of Interest Name of Company or Business Entity agnes beane sidbury llc The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 12 C (1). For each non-publicly owned company or business entity (the “primary company”) identified in question 3.C above, please list the names of any other companies or business entities in which the primary company owns securities or equity interests valued at over $10,000, if known. Non-Publicly Owned Company or Business Entity (the Primary Company) Other Companies in which the Primary Company Owns Security or Equity Interests None or Not Known C (2). If you know that any company or business entity listed in 3.C or 3.C(1) above has any material business dealings or business contracts with the State of North Carolina, or is regulated by the State, provide a brief description of that business activity. Name of Company or Business Entity Description of Business Activity with the State None or Not Known 4. As of December 31, 2014, were you, your spouse, or members of your immediate family the beneficiaries of a vested trust with a value of $10,000 or more that was created, established, or controlled by you? Do not list assets held in blind trusts. See 2015 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” Yes No Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2014, did you, your spouse, or members of your immediate family have liabilities of $10,000 or more, excluding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student loans, personal loans and intra-family debt. Yes No Name of Debtor (You, Spouse, Immediate Family Member) Type of Creditor (Commercial Bank, Credit Union, Individual, etc.) The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 12 6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your immediate family during 2014. Include salary, wages, state/local government retirement, professional fees, honoraria, interest, dividends, rental income, business income, and other types of income required to be reported on your State and federal tax returns. Do not include income received from the following sources: Capital gains Federal government retirement Military retirement Social security income/SSDI Recipient of Income Name of Source Type of Business/Industry Type of Income I had no reportable income over $5,000 in 2014. See Attached PROFESSIONAL AND CIVIC RELATIONSHIPS 7(a). During 2014, were you, your spouse or members of your immediate family a director, officer, governing board member, employee, independent contractor, or registered lobbyist of a nonprofit corporation or organization operating in the State of North Carolina primarily for religious, charitable, scientific, literary, public health and safety, or educational purposes? Yes No If "No", proceed to question 8. Do not list State boards or entities, or entities created by a political subdivision of the State. Do not list organizations of which you are a mere member. Name of Person His/Her Position Name of Nonprofit Corporation or Organization Nature of Business or Purpose of Organization 7(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive State funds, please provide a brief description of the nature of that business, if known or with which due diligence could reasonably be known. Name of Nonprofit Corporation or Organization Describe State Business or State Funding None or Not Known The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 12 Please answer the following question as it pertains to the following board/agency: UNC Wilmington Trustees 8. During 2014, were you, your spouse, or members of your immediate family a director, officer, or governing board member of any society, organization, or advocacy group with an interest in matters over which your agency or board may have jurisdiction? Yes No Legislator/Judicial Officer - You are not required to complete this question if you are filing because you are a legislator or a judicial officer or you are filing as an appointee to those offices. Do not list organizations of which you are only a member (not serving in a leadership role). Name of Person Name of Society, Organization or Advocacy Group Leadership Position (Director, Officer, Board Member) 9(a). List the name of each company or business with which you were associated where you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of Name of Person Relationship to Filer Name of Company Role of Person No Business Associations 9(b). If you know that any company or business entity listed in 9(a) above had any material business dealings or business contracts with the State of North Carolina or was regulated by the State as of December 31, 2014, provide a brief description of that business activity. Name of Company or Business Entity Description of Business Activity with the State Not applicable (No entities listed on #9a) No relationship / Not known The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 12 10. Are you a practicing attorney? Yes No Judicial Officer/State Attorney If “Yes”, check each category of legal representation in which you or the law firm with which you are affiliated has earned legal fees of more than $10,000 during 2014. Administrative Admiralty Corporate Criminal Decedent’s Estates Environmental Insurance Labor Local Government Real Property Securities Tax Tort litigation (including negligence) Utilities Regulation Other category not listed. 11. During 2014, were you a licensed professional (other than an attorney) or did you provide consulting services individually or as a member of a professional association for which you charged or were paid over $10,000? Yes No Type of Business Nature of Services Rendered Please answer the following question as it pertains to the following board/agency: UNC Wilmington Trustees 12. Are you or your employer, your spouse or members of your immediate family, or their employer currently: • Licensed by the State board or employing entity with which you are or will be associated or • Regulated by the State board or employing entity with which you are or will be associated or • Have a business relationship with the State board or employing entity with which you are or will be associated? Yes No Legislator/Judicial Officer - You are not required to complete this question if you are filing because you are a legislator or a judicial officer (“judicial officer” is defined in the SEI Helpful Tips) or you are filing as an appointee to those offices. Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 12 13. Are you, your spouse, or a member of your immediate family currently registered as a lobbyist or lobbyist principal or were you registered as such within the 12 months preceding your filing of this form? Yes No Name of Lobbyist Lobbyist’s Principal Date of Registration Registration Expiration OTHER DISCLOSURES 14. During any calendar quarter in 2014 (but only the time period after you were appointed, employed or filed or were nominated as a candidate), did you • receive any gift(s) exceeding $200 per quarter from a person or group of persons acting together, and • when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and • the gift(s) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying? Yes No Do not report gifts given by members of your extended family. Do not report gifts that have previously been reported by you to the Department of the Secretary of State on the "Expense Report for Exempted Persons." Date Item Received Name and Address of Donor(s) Describe Item Received Estimated Market Value The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 12 Please answer the following question as it pertains to the following board/agency: UNC Wilmington Trustees 15. During 2014 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) did you • accepted a “scholarship” exceeding $200 from a person or group of persons acting together and • those person(s) were outside North Carolina and • the scholarship was related to your public position? A “scholarship” is a grant-in-aid to attend a conference, meeting, or similar event. Yes No Judicial Officer - You are not required to complete this question if you are a judicial officer or you are filing as a judicial officer appointee. Do not report gifts that have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted Persons.” Legislators are not required to report scholarships paid by a nonpartisan legislative organization of which the legislator or the General Assembly is a member or participant or an affiliate of that organization. Date of Scholarship Name and Address of Donor(s) Describe Event Estimated Market Value Please answer the following question as it pertains to the following board/agency: UNC Wilmington Trustees 16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or another Council of State member? Council of State members are: • Governor • Lt. Governor • Secretary of State • State Auditor • State Treasurer • Superintendent of Public Instruction • Attorney General • Commissioner of Agriculture • Commissioner of Labor • Commissioner of Insurance Yes No If “Yes”, list all contributions you (NOT immediate family members) made during 2014 with a cumulative total of more than $1,000 to the Governor or other Council of State member who appointed you. Contributions are defined in N.C.G.S. 163-278.6(6) and include, but are not limited to, “any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” Date Amount Contributed to No contribution(s) with a cumulative total of more than $1,000 The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 12 Please answer the following question as it pertains to the following board/agency: UNC Wilmington Trustees 17. Are you an appointee or prospective appointee to: a. the head of a principal state department (e.g. cabinet secretary) appointed by the Governor; or b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court Judge; or c. a member of any of the following boards: • ABC Commission • Coastal Resources Commission • State Board of Education • State Board of Elections • Division of Employment Security • Environmental Management Commission • Industrial Commission • Human Resources Commission • Rules Review Commission • Board of Transportation • UNC Board of Governors • Utilities Commission • Wildlife Resources Commission Yes No If "No", proceed to question 18. d. If so, were you appointed or are you being considered for appointment to that public position by a Council of State member? Council of State members are listed in question 16. Yes No If "No", proceed to question 18. e. If so, you must indicate whether during 2014 you (not immediate family members) engaged in any of the following activities with respect to or on behalf of the candidate or campaign committee of the Council of State member who appointed you to your public position: i. Collected contributions from multiple contributors, took possession of such multiple contributions, and transferred or delivered those collected contributions to the candidate or committee? Contributions are defined in question 16. Yes No ii. Hosted a fundraiser at your residence or place of business? Yes No iii. Volunteered for campaign-related activities, which include, but are not limited to, phone banks, event assistance, mailings, canvassing, surveying, or any other activity that advances the campaign of a candidate? Yes No 18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon of innocence; or (ii) an order of expungement regarding that conviction? Yes No Offense Date of Conviction County of Conviction State of Conviction The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 12 19. Are you aware of any other information that you believe may assist the State Ethics Commission in advising you concerning your compliance with the State Government Ethics Act? Yes No If yes, please provide such information below. AFFIRMATION I affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. I also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Children) are public record. I acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest under this Article shall be guilty of a Class 1 misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest as required under this Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I Agree. It is my intention that this check box constitutes my electronic signature. By checking this box I certify that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. agnes rankin beane **Notarization is no longer required** Printed Name Filed Electronically 5/20/2015 Signature Date The SEI and any attachments, excluding the Confidential Form, are public records. Page 11 of 12 The SEI and any attachments, excluding the Confidential Form, are public records. Page 12 of 12