Albert Andrew Corbett, Jr.

Far STATE ETHICS COMMISSION Date Received: Ble | 5 2025 STATEMENT OF ECONOMIC INTERE! { Kir oreo ST | | RECEIVED NE No Change Form APR 01 2025 This entire form must be completed to fulfill or SEE ing obgasion: — ETT LTT i A A he Ee IN Ey Wr TL Conthame aur (Me. [ Alley Andy rly Jr. — eas to aly omits sees | “State Goverment Job or Filing Post-Service (Specify agency and | Board] Commission (List the complete names of ail State bourds. ER en oe Foi SEL “ne de ned Dishack 7 JR— Tvave coetty cevionsd my most recy led Satan of canoe Inst Lon For nd my esonees ann Licks AA AA de : vas oo tre ond wil ok oct ary ace, rho property for te purpose of concen rom rn ae Sento A eI PE ven AEA —————— PE — ing verso we nowy comets Kiya cle formation at ried . cised EB eo en atts Sri Sn Nom § Foetn pensey oe ration, is oh roe os peat 3 tof cng est. ng he Ee a aco an 3b attr unde penalty of pry that te foregoing rue and correct Sore ee + A v Eat Submit signed, orginal documents only. Do no a or e-ml this form: F—

FOR STAFF USE OWT CRN STATE ETHICS COMMISSION Oat Received hi il 9 2024 STATEMENT OF ECONOMIC INTEREST RECEVED YT No Change Form This entire form must be completed to fulfill Your SEI filing obligation. NCETHIS COMMISSIO Files Name (Fst, Midd, Lost [protic [eirsttame | middle ame | tasthame | sux EC IS CR I Reason for Filing (Complete all that apply.) State Government 1b (Speci agency and postin.) | Board/Commissin (Ust the complete ames of 1 Sate boards on which you are serving o are beng considered.) Coren Serving 3% 3 JaicRT Officer (Speciy fice) | Carvery Serving 35 5 [eglatr (Speci House ar Senate) Emergency District Court Judge re you s CANDIDATE for s covered elected ofice? IF yes, speci ofice and GIsiccounty 1 applicable: (istrict, Supreme, or Superior Cour; Court of Appeals; Clerk of Court; DA; Legisiator; Member, Council o State) Oves Eno AFFIRMATION Ihave careful reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue 0 be true, corect, and compete to the best of my knowedge and bel have not transfered, and will ro transfer, any asst, interest, o property for the purpose of concealing it from disclosure whi retaining n equitable interest Yunderstand that my No Change Form is a publi recor have read and understand the folowing statutes: N.C.G.. § 1384-26. Conceaing or fling to disclose material information. A fing person who knowingly conceals or knowingly ais o discos information tht is required tobe lscosed on statement of economic interes. - shal be Quy of a Cass 1 Misdemeansr and subject to deiphmary Scion under G.5. 138A.45 NCGS. § 1384-27. Pena for fale information A fing person who provide fais information ona statement of econamic interest knowing tht the Information false Quit of Clas elon and hall be Subject 1 Gslpinary action under ro. 304-45. T affirm under penalty of perjury that the foregoing s true and correct, 04/03/2024 Siomature ewe Albert A. Corbett, r eda. Submit signed, original documents only. Do not fax or e-mail this form. This document is a public record.

or sat Use only. GTR STATE ETHICS COMMISSION one Reems AE CEIVED \f1/@/i] 2023 STATEMENT OF ECONOMIC INTEREST This entire form must be completed to fulfill your ethics filing obligation. NG ETHICS COMMISSION [we [aber Rees State Government 0b (Speey agency and posion) | Board Commission (Lat th complete names of a State Soards on which you are ening o are being considered.) Emergency Distict Court Judge OO] Feat Serves Fl (Spec OCs Had Tv 307%, 55. Todae, legisttor, district attorney, or dericof court) Ao any mmEAate Tam mEmDersT FESOE In your RousehoIeT OvYes Eno «Immediate fami” incudes your spouse (unless legally separated) and unemancpated minor children (under 16), It also includes members of your extended family (your and your spouse's children, grandchildren, parents, Grandparents, and Sibinge, 3nd th spouses of ach of hose persons) who reside in your household. List te full vam of all immediate family members residing in your ousehld: List uremanciated minors on separate form. Minor may be emancipated by mariage, enisument nthe US miliary, or our order for emancipation. re | re | a i he SEX and any attachments, excluding the Confidential Form, are public records Paget ort ‘Unemancipated Property Interests PYes [ONo | ownerof Real Estate| 5% ownership Tnterest | Location by city Location by County lr loo sminen sr oo aapamce Pamico SA OvYes ENo vametrume | emeotsan | estore GYes [Ono lr sounem Compan ls [Veron [ser [usiCorporation [sr [eankotamerca Self Self Atlantic Bank Shares OvYes ENo RYes [No re ES HYes [ONo (1 had no reportable income over $5,000 in 2022. Abert A Comet ir, |mmanmeceaoecors | adil Dopament [Emery Albert A. Corbett, Jr. 1401 (K) Retirement Retirement 7(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive [JNone or Not Known emearrenn | tsp ore | ame orcoman | won| I EE EE I EE EE I EE EE EE I EE EE I EE EE I I EE A I I EE 10. Are you a practicing attorney? [0 Administrative [J Admiralty [Corporate OCriminal [J Decedent's Estates. [0 Environmental [insurance Otabor 0 Local Government [Real Property [securities OTax negligence) rr rr rr] 12. Are you or your employer, or any members of your immediate family, or thelr employers currently: + licensed by the State board or agency with which you are or will be associatedor + regulated by the State board or agency with which you are or will be associatedor + ina business relationship with the State board or agency with which you are or will beassociated? ves [J No i Legisator/ Judicial Officer - You are not required to complete this question i you are fling because you are a legislator or 2 judicial offcer or as a candidate or appointee to those offices. However, you are also fing as a member of a State board or as » tate employee, please answer “yes” or "no" to this question. If you respond "yes," provide additional information. Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) 13. Have you or a member of your Immediate family been registered as a lobbyist or loBbylst principal within the 12 months preceding your fing ofthis SEI? Oves @no Lobbyists Principal Date of Registration Registration Expiration 14. During 2022, after you were appointed, employed, o fled or were nominated 2s a candidate, did you + receive any “gif(s)" exceeding $200 per quarter from a person or group of persons actingtogether, + when both you and those person(s) were outside North Carolina, + under circumstances that would ead a reasonable person to conclude the gifts were given forlobbying? To answer Yes, al three conditions must apply. Oves no > Do not report gifs given by members of your extended folly. > Do not report gifs you have previously reported on the “Expense Report or Exempted Persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received [mga | The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 [ClYes [INo )udicil Officer - You are not required to complete this question if you are filing as a judicial officer Date of ‘Name and Address of Donor(s) OvYes ENo No contribution(s) with a cumulative total of more than $1,000 [rr p—— PE TT FR ppm s—p—r— ero b. 8 North Corona Supreme Court Juste; o a Cour of Appel, Super, or Sant Cou ocho a member of any ofthe allowing boards Ove ON 2" ec Commision No” proceed to question 15. © Consol Resources Commision Ste oar o Education State Board of Eectons. + vision af Employment Securty + Environmental Management Commision * Industral Commision Pp — 3 Sule Review Commision 1 somtotharsponaton © tities Commission © wide Resouces Commision PY FA WT e—— TT eins ono ote amon a ston 5, «Tr you mut nate whethr Gui 2022 you engaged nay of the iy Sees wih pan Bon of se maton or eran omries oe Com FS rarer whe pone © Cotte conrbutons rom mule contr, ook possess of such dil. omens and satoras of sdered ose” emotes Comtions oe esos or oEES i Hosted a fundraiser at your residence or place of business? pr Ep —— Sesstance malings, camara, Sued, or sn omer sats tet (ves CINo Sevances tn Campion a cna? 5 Have you ovr been ceicted of a any for whi yo Fave nt receved akhers 1) prdar o (1 am ardor of Cepungaments Oves ENo [ ofems | oateot comiction| county of comvietion | ste of comvition 5. Are you aware of any othr formation ta yo ble may ast th Eee Commission adwig vou Conc You compare wih te rts Govern, Eos 7 [OYes [No If yes, please provide that information below. The SEE and any attachments, excluding the Confidential Form, are public records. Pagesor10 The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate tothe best of my knowledge and beller. 1 have not transferred, and wil not transfer, any asset, interest, or property fo the purpose of concealing it from disclosure while retaining an cquitable interest understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding Unemancipated Children ae public records. Ihave read and understand the following statutes: NCGS. § 1384-26. Concealing or falling to disclose 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 gulty of a Class 1 misdemeanor and subject to disciplinary action under G.5. 1384.45, NCGS. § 1388-27. Penalty for false information. A fling person who provides false information on a statement of economic intrest . . . knowing that the information i aie I guilty of a Class H felony and shal b subject to disciplinary action under G.5. 138A-45. Taffirm under penalty of perjury that the foregoing is true and correct. 0 ” _ 03/23/2023 Signature DD Date Albert A. Corbet, Jr Printed Name Submit signed, original documents only. Do not fax or e-mail this form. | The SEX and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

_ rons GTR \ STATE ETHICS COMMISSION — Bho) RECEIVED REI@J 2022 statement oF Economic INTEREST = | WR1L 22 This entire form must be completed to fulfill NC ETHICS COMMISSION Your ethics ling obligation. ars Wane Cem ee a EE or LS TT RTT ETH Mr. | Abert Any Corvett Is I FS Retired 1 Reason for Filing (Complete all that apply.) Se Govern 08 Sey een nd psion) | Beard Commision (Le oe Tams RT Cray Sing 55 3 A Offer pea oe) Corny Emergency istic Gout huge rr 1] re you 3 CANDIDATE for a covered sicted aficer| [1 Yes, Lik office nd Dstit/ County (1 apne) (itt Spero, or Supreme Gr, Cou of Appel, LEA I [JYes [XNo | Oo ther Immediate family momers resid In your household? Oves ENo Ty op ——_—n out of ro Svs wie reste ih your mosseRl: tin Brest oe SEE AIT Trae ete Tage Fen i 5 Tm a net snare The SEE and any atachments, excluding the Confidential Form, are public records. Page ori ‘Unemancipated p—— Ee EY ry TR = = EC Name of Lessee If Real Estate, Location If Personal Property, | (Renter) by City & County Describe. XYes [No Self ‘Southern Company Self | Verizon 1 TT OvYes [No ‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol) [Yes [No - If “No,” proceed to question 4. Owner of Interest Name of Company or Business Entity C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the names. [0 None or not known Yes [No Eves [INo immediate family during 2021. Include salary, wages, state/local government retirement income, professional fees, | fees Aor Cat er pr [e— Professional and Civic Relationships 7(2). During 2021, were you or any 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 North Carolina primarily for religious, charitable, scientific, fiterary, public health and safety, or educational i purposes? DYes [I No- If “No,” proceed to question 8. > Do not lst State boards or entities. > Do not st organizations of which you are a mere member. Name of Nonprofit Nature or . Corporation or Organization | Purpose of Organization 7(6). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive: State funds, briefly describe the nature of that business, If known or with due diigence could reasonably be Known. Name of Nonprofit Corporation or Organization Describe State Business. CINone or Not Known 5. During 2021, were you or any members of your Immediate family a director, officer, or governing board member of any sadiety, organization, or 3dvocacy Group with an interest in matters over which your agency oF board may have Jurisdictions OYes (No []Legisiator/Judicial Officer - You are not required to complete this question if you are fing solely because you are a legislator or Judicial officer or as a candidate or appointee to those offices. However, If you are aiso fing as a member of a State bard or as a State employee, please answer “yes” or “no” to this question. If your response Is ys,” provide additional information. » Do not ist organizations of which you are only 2 member and do not serve in 3 leadership role. Name of Society, Organization, Leadership Position or Advocacy Group (Director, Officer, Board Member) The SE and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 EE EE Ee —— rr rr rr = I I EE [ rr £3 EN EE A = Emr EA EE Description of Business Activity with the State rr = rr 1 rr I I I | 10. Are you a practicing attorney? OYes [No [EF Judicial Officer/State Attorney FE ete masmmaaili me [J Administrative 0 Admiralty O Corporate 0 Criminal [J Decedent's Estates. OJ Environmental Dinsurance 0 tabor OJ Local Government. (CJ Real Property. 0 securities OTax DI Tort litigation (including [J utilities Regulation [J Other category not listed negligence) I AA Fe RP ER ED a ra | rr | I tei se irr rei Fr pp —— pO ———— + ans by the State board or agency with which you are or wi be asocated or related by th Sate board o agency ith which you ae or il be sociated oF + ina busines eas with th State board or agency with which you are or wil be associated? [es CINo El Legiatornudial Officer - You ar not require to complet this question ou ar lng because re isto a fi oT oa CocRe o appa 10 tess ES: However you re 2 Hin 353 roa of 3 Gat Bours of a5 Sas employe, kas aver ye ac vs Question I you espa ves, provi dion forte: Name of Employer Type of Relationship ir applicable) (iconsing, Regulatory, Business) 5. Wave you or 2 member of your Immediate family been registered 55 Obs of obit pvc! win he 12 ant prsceding your fing of hs form? Ove mo Nome of abbyist | Lobbyists principal pret | tare | negation | Expiration Other Disclosures 14. During 2021, aftr you were sppainted, ered, o fled o wer nominated 5 3 candi, 4d ou + recive any “gs” exceeding $200 pa are fom a person a group of persons acting together, © ihn bth you and thas parson) wee outside North Carols, © under creumstances tha would ad a reasonable perso to conclude th gifs war gn or abying? To answer Yes, ll rea conditions must aly. Ove mh > Do nt repr ifs given by members of your extended amily. > Do no repr ifs you have previusy reported on th “Expense Report or Exempted Parsons.” [ote tem Reaves | am ns Adress of Door) | ovo om ceived | seid res | The SEE and any attachments, excluding the Confidential Form, are public records. Page 7or10 Date of ‘Name and Address of Donor(s) 1 ‘State member? Comat tr mamers se Oves [No » Contributions are defined broadly in N.C.G.S. 163-278.6(6) and include “any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” | BI No contribution(s) with a cumulative total of more than $1,000 17. Are you an appointee o prospective appointee as: a. the head of a principal tate department (e.g. cabin secretary) appointed by the Govemor; o 5. 2 North Carolina Supreme Court Justice; or a Court of Aspeals, Superior, or Disret Court Judge: or ca member of any of the following boards: Eves Ono + ABC Commission No,” proceed to question 18. + Coastal Resources Comission + State Board of Education + State Board of Elections + Division of Employment Security + Environmental Management Commission + Industrial Commission + Human Resources Commission + Rules Review Commission | + Bowd of Transportation + tities Commission + Wife Resources Commission 4 1050, were you appointed or are you being considered for appointment to that | J Yes [No postion by 5 Councl of State member? oN procend t question 16. If 50, you must indicate whether during 2021 you engaged in any of the following actives ih respect to or on behalf of the candidate or campaign Commitee of the Council of State member who appointed you: i Collected contributions from multe contributors, tack possession of such multiple contributions, and. transiered or Gelvered. those. collected | [1¥es CINo Contributions to the candidate or commitee? I. Hosted a fundraise at your residence or place of business? Oves Oo ii. Volunteered for campaign-relted activites, including phone banks, event assistance, malings, canvassing, surveying, or any other aciity that | I¥es [INo advances ha campaign of a candidate? | | 18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon; or (i) an order of expungement? Oves No TL ET 19. Ave you aware of any other Information that you belleve may assist the Ethics Commission In advising you concerning your compliance with the State Government EUNEs Act? [Yes [No 1fyes, please provide that Information below. The SEX and any attachments, excluding the Confidential Form, are public records. Page 9of 10 Affirmation The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate 0 the best of my knowlecge and blir, 1 have not transferred, and will ot transfer, any asst, interest, or propery for the purpose of concealing I from disclosure while retaining an equitable Interest. 1 understand that my Statement of Economic Interest and any attachments except fo the Confidential Form regarding Unemancipated Children are public records. Ihave read and understand th following statutes: N.C.GS. § 138A-26, Concealng or falling t disclose materi! information. A fling person who knowingly conceals or knowingly falls o disclose Information tha s required to be disclosed on a statement of economic Interest. shall be quity of 8 Cass 1 misdemeanor and Subject to Gcpnary action Under G.5. 136A-45, | NCGS. 5138827. Penaty fr aise information, A fling person who provides false information on a statement of economic Interest... knowing that the Information i fase 1s Quit of Clos H felony and shll be subject to discpinry action under G.5. 138A-45. Tafirm under penalty of perjury that the foregoing is true and correct. C Yolo 2 Signature Bare | Abert A. Corbet Jr. | Fem. ‘Submit signed, original documents only. Do not fax or e-mall this form. The SET and any attachments, excluding the Confidential Form, are public records. Page 100 10

5 EE ZEA GT STATE ETHICS COMMISSION — ahs Lal 2021 STATEMENT OF ECONOMIC INTEREST RECEIVED &7 NO CHANGE FORM This entire form must be completed to fulfill | APR 15 20 Your SEI filing obligation. | INC ETHICS COMMISSION | Fier Nam (rvs, vide, ase | Prefix | First Name Middle Name Last Name Suffix Me | Alert Andy ‘ot 4 Reason or Fes (Comper air tna 309) Site Government a3 (Spey 330m and pasion) | Boar Commas (Lat i compete names ofa Sos Sour on whe yo are sero re pom conseret) | Judicial Officer (Specify office.) _ | Legislator (Specify rouse or Senate.) nec eg Diack (ong Tide rao ; nave Gartuly reve my most recently ied Statement of Economic nares Long Form and my resanses continue [1556 re, coed, and compat t 1 Best fr knawiade and pe! have not transfered, and wil not rarer, any 8st, nerest, or property for the purpose of concealing rom scosuns whit rearing an enuRable mires unerstan tsk my No Change Form i. pai reco 1 have read and understand the following statutes: ! NC.G5.§ 1384.26. Conceal or ting to discose material formato. A ing persan uo knowingly conceals or knowingly as to dios informatio that 1 recuied b disclosed Gn Sonement of econo eres shall be aul fa cos 1 sdemennt and Sunset to daca Seton ander 8. 158045. HCG. 5 1388-2, Penaty or aise information. fin person no provices ise information an 8 stlement of economic rest... knowing tat the armen fa 5 gui of Cats fry and shall be siya 10 cman scion under G3. 136-45. Tatfrm under panalty of peiury thatthe foregoing is true and correct Qa alan | Se 7 Bate Mok (Ade tt Tor Printed Name Submit signed, original documents ony. Do not fax or e-mail ths form. | This entire document is a public record.

A E ETHICS COMMISSION ie vee a) did 0) [eBEcevep | Cdl 3) 2020 STATEMENT OF ECONOMIC INTEREST | | EF NO CHANGE FORM APR 8 200 This entire form must be completed to fulfill NCETHICS COMMISSION | your SEI filing obligation. | cree or cmon Saammes one. enersainge ov Fiers Name (Fr, Middle, Lost) profi | FirstName | widdiename | LastName [sux | Me | Bloat | Mg, | Colett [@ Reason for Fling (Complete al tnt apy) Ste Govermmen 95 (Spey S7en and pasion) | Board Commision (Late compete ames of al State Soars on which you are serung rare bin consderea) Sudcl Officer (Spec office) Cegtotor (Specty House or Senate) iC AFFIRMATION | rave core reviewed my mst recent led Statement of Economic Interest Lang Form and my responses continue bere, cote, ana comple the best of my Knowledge and Sle! have not transferred, an wil not transfer, any asst, interest o property for the purpose of concealing fom Gisiosue whi resining an sauna meres understand that my No Change Form i » pub recor, hove read and understand th follwing sates: N.C.GS. § 138826. Conceaing o fling to isciose material information. A fing person ro knowingly conceals or knowingly falls to slog formation tht i equred tbe cisciosed | aren of etamome rest Shall be Quy of a iss 1 misdemeanor and subject to dscpinany | Seon ander G5. 1390-45. NCGS. § 13827. enaity for fis information. A fling person who provide fle information on a satement of economic terest. knowing tha the armaohon oe guy af 5 Class 1 ean an shall be Sunfect v @dpinay acon under G5. 1304-5. | affirm under penaity of perjury that the foregoing is true and correct. 3-30:200D Signore Bate Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This tire document is public record.

| ur RECEIVED om | One Receves Eihae) STATE ETHICS COMMISSION | APR - 32018 (Ae Nl) 2019 STATEMENT OF ECONOMIC STATE ETHICS COMMISSION INTEREST & Checked for completion This entire form must be completed to fulfill A somes Gome your ethics filing obligation. Incomplete Gs ____ Supp. sent date br Supp. receives dite entered in dotabase by Pebied |] hire on which you are serving or are being considered. Sutil Officer (Spey fice.) A. Do other imediate family members resid in your household? Oves no On ths form, “immediate family” includes your spouse (unless legally separated). It also includes members of your extended family (your and your spouses children, grandchildren, parents, grandparents, and siblings, and the spouses of cach of those persons) who reside in your household. List the full name of all adults and emancipated minors in your household. Minors are children under 18. They are emancipated by marriage, enlistment in the US miliary, or cour order for emancipation re Emancipated Minors The SEI and any attachments, excluding the Confidential Form, are public records. Page 10110 B. List only the initials of al unemancipated minors in your household below. A minor is a child under 18 years od. List the full name of each minor child on the Confidential Form at the end. ‘unemancinated Property Interests 1. As of December 31, 2018, did you or any members of your Immediate family: A. have on ownership interest n North Carolina real estate (including your residence) with a market value of $10,000 or more?’ oe Ono | Owner of Real Estate | 9% Ownership Interest | Location by City Location by County ©. lease or rent rea estate or personal property to or from the State of North Carolina with a market value of $10,000 or more? ove whe 1f Real Estate, Location | 1f Personal Property, by City & County Describe 2. Atany time during 2017 or 2018, did you or any members of your immediate family sll t or buy from the State of North Caroling personal property worth $10,000 or more? DOves we [ Nameorpurchaser | Name of seller [typeof property ‘The SEX and any attachments, excluding the Confidential Form, are public records. Page 20f 10 3. AS of December 31, 2018, did you or any members of your immediate family own any of the following financial Interests valued at $10,000 of more? List each company individually. A. Stk in a publicly owned company? Des Ono Do oot st terests in widely held investment fund (Including mutual funds, regulated investment companies, or pension or deferred compensation plans) I. 1 the und Is publicly raded or Rs assets are widely diversified; and 2. neither you nor an immediate fami member are abl to contol the underlying assets Owner of Interest Full Name of Company or ticker symbol YE [7777 SA 5. Stock options In a company or business? ove oo Owner of Stock Option Full Name of Company (Do not use a ticker symbol) C. Interests i a non-publicly owned company or business entity? These Include Interests In sole proprietorships, Barinerships, Imied partnerships, som ventures, mike abilty companies imted lability partnerships, and Closely held corporations ves [plo 1No, proceed to question 4. (2) For each company or business entty Identified in question 3.C. (the “Primary Company”), please Ist the names of any other companies or Business entiles In which the Primary Company own securities or eguly interests volued at over $10,000, f known. Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the primary Company) ‘Owns Security or Equity Interests Cane or not known The SEX and any attachments, excluding the Confidential Form, are public records. Page 30f10 C2). 1 you know tht any entity sted in 3.C or 3.C(1) above has any materia business dealings or business Eonacts with th Sto of North Carolin: or regulated by the tat, briefly describe tha business acy. ‘Name of Company or Business Entity Description of Business Activity with the State sof December 31, 2018, were you of any members of your Immediate family the beneficaries of 3 vested rust with Value of £10,000 or more that you created, stabiehed; or controled? Do not list assets held in blind trusts. See 2019 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” Oves xo Sees ong Susrecs OL Tree pazsriptom ST Tree Fr 5. As of December 31, 2018, dd you any members of your Immediate fami have labiltes of $10,000 or mare, excluding he oriaage on your primary personal residence? Examples include credit cod debt, auto ans, student loans, personal fans and intr fami debt. we On Name of Debtor Type of Creditor (commercial Bank, credit union, individu, ste) List cach source of income (not specific amounts) of mors than $5,000 receved by you or any members of your immediate fami during 301. Include Salary, wages, tate/ocal Goverment retirement income, professional fcs, Honora, ntarest, Guidends, rental income, Buses income, and othr types required to be reported on Stte and federal ax resus. Do no incu Income received rom the folowing sources: » Capital gains » Federal government retirement > Miltary retirement > Social securty income/ SSDI Type of Type of Income Blainess/Industry [11 had no reportable income over $5,000 in 2018. Abret A-Cotockt Te. "PHBE [Lis Deptt [Rehunund, Erg The SEX and any attachments, excluding the Confidential Form, are public records. Page 4of 10 Professional and Civic Relationships 70a). During 2018, were you or any members of your immediate family 3 director, officer, governing board member, Cmpioyce, Independent contactor, a Tegserka lobbyist of 3 nonproft corporation o argantation aperating In North Carona primary for religious, charitable, scientific, eray, public health and safety, o educational purposes? ves [fo - 1f "No," proceed to question 8. Do not Ist State boards or ens. > Do not Ist organizations of whieh you are a mere member. p20 not ist organizations of whch you ave 8 ere member. Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 700). If the nonprofit corporations or organizations sted above do business with the State of Noth Caroline or receive State funds, brie Gescroe the nature of tnt business f known or with due dligence coud reasonably b known Name of Nonprofi Corporation or Organization Describe State Business 5. Buring 2018, were you or any members of your Immediate family a directo, ofice, or Governing Board member of a Society, organiiaton, or AUGGACY aroup ith an eres In matiers over whch your agency or board may have Jorscton’ ves Cio egiiator uci Officer - vou ae not required to complete this question you ar fing because Jou are a egiator or sudiil afice or you are Ang 2s an appintee o one of tose offices. Do not list organizations of which you are only a member and do not serve in a leadership role. ‘Name of Society, Organization, Leadership position or Advocacy Group. (Director, Officer, Board Member) The SET and any attachments, excluding the Confidential Form, are pubic records. Page 5 of 10 9(a) List the name of each business with which you were associated where you or a member of your immediate family Was an employee, director, afcer, partner, proprietor, o member of manager 35 of December 31, 2018 Ro Business Associations (6). If you know that any entity sted In (a) above had any material business dealings or business contracts with the State of North Carolina or was regulated by the State 8s of December 31, 2018, briefly describe that acy. Name of Company or Business Entity Description of Business Activity with the State Not applicable (No entities listed on #92) 10. Are you a practicing attorney? Oves ONo (fC Offcertate Attorney 1°Ves", check cach category of legal representation in which you or the aw firm with which you are afflted has omed legal fees of more than $10,000 ring 2015 0 Administrative 0 admiraiy corporate Ocrminal 0 Decedent's Estates Environmental Cltnsurance Otabor J Local Government. [Real Property (0 Securities OTax DO Tort litigation (including 0 utilities Regulation [OJ Other category not listed negligence) 11. During 2018, were you a licensed professional (other than an attorney) or did you provide consulting Services indvioualy oF as a member of a professional association or WhIEh You charged of were paid over $10,0007 Oves fo Type of Business Nature of Services Rendered The SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. Ae you ar your employer, or any members of your immediate family, or thir employers curenty: licensed by the State board or agency ith which you ae o willbe associated or regulate by the Sate board or agency with which you re or wil be associated or in’ busines elatonship with the State board or agency with which you are or wil be associated? Ces CINo [eoilotorudical Officer - You ae not required to complete this question f you ar fing because re eltor of a ical ofce. a you are in os an appavies 10 one of thos ofees Name of Employer Type of Relations if applicable) (icensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal within the 12 1 Tonite receding your Tog of i orm Oves fo Name of Lobbyist Lobbyists principal Date of Registration Regmration | "Expiration Other Disclosures 14. During 2016, afer you were Sppaed, employed, or ed or wee marinated # andre, 4d you receive any "()" exceeding $200 pe quate rom a person o group of persons acting together, Whe both you and these person(s) were outside North Caraina, under drcumstances tht would lead reasonable perso to Conclude the gts were given or oBbying? To answer ge, all tree condions mst spl. > Do mot report gf Giver by maTers of your extended a. > Do no repr ifs you have previously reported onthe "Expense Report for Exempted Persons Date Item Received | Name and Address of Donor(s) | Describe Item Received | _ Estimated Market Vous | The SEL and any attachments, excluding the Confidential Form, are public records. Page 70f10 15 During 2018, ser you ware sppaned, ployed, or fied ar wre nominated 2 8 andoae, 4d you cap 3 chars" exceeding $200 elated to Your public postion fram a pasen a group of parsons acting ih « wher thos person(s) were aude North Cralina? To ones Yon von contr nt ap A ~echolarahip” {8 grantincai, ether direc or indirect, attend & conference, meeting, or similar retin iio wave vagy este ond ovr cio anpemtas: Yes [IN cca Officer - You are not required to complet this aueston if you are a ud officer or you are Fa ot ote appara: Do not report ts you have previously reported on th “Expense Report for Exempted Parsons.” Lcislatos are nok ruled t report schaarship paid by nonpartisan legislative organization of which the legislator | or the General Assembly is a member, participant, or affiliate. | Date or | Name and Adress of Donor) Deserve Event promr— scholarship Verue 6. Rave you bee appointed or carder for Sppoment 1 3 covered board by the Gavaror o anther Counc of See members Council of State members are + Governor » 1. Governar » Secretary of state + Store sutton + State Teaser + Superintendent of Publi Instruction + Atorney General » Commissioner of Arcure = Commissioner of Lab + Commissioner of naurance Ove of 16-Yes, lis all contributions you made in 2018 with a cumulative total of more than $1,000 tothe Counc Svat maria who pated Your io chute communis from immediate emily members, + Contributions re defined broadly n N.C.G.5. § 1634-1411(13) and include “any acvance, conveyance, dost; mr rato of Ro eh povint Hh. pcs of sleet of moray or VG of vis — [owe [amen] Contributed to fo contutionts) with 3 curt otal of more thn 51,000 The SE and any attachments, excluding the Confidential Form, are public records. Pages or 10 17. re you am appontes of prospecie appomes 5 a the head of 2 principal ate department (.., abet secretary) spponted by the 5. a North Carolina Supreme Court utc, Cour of Appeals, Superior or District Coun Soages or ca member of any ofthe follwing boar: hac Commission ~ Cosstl Resources Commission + State Board of Education Wes Cine State Bord of Elecons Owsion of Empayment Securty Xoo proceed to Eneronrmerial Management Cammssan aston 18. ~ icusil Commission Haman Resource Commission Rule Revie Commistin Saad of Transportation © ORC Board of Governers Units Commission © Wide Resources Commission 4 1 s0, were you append or are you being considered fo appoint to hat | Jes fo Sonam oy Count of tae memes oe eed to auestion 18. osm, you must Indicate whether during 2018 you engaged nay of the along nies wie 455k to oh bona of te andre of capa mee of Te Counc of Sore member who appomted you I. Collated contributions from multiple contributors, took posession of such ii Coninatons, and wales o delered hos coleied Correia fo the cinadoe or ommtes? 1 nosed s urdratser at your residence o place of unas” [Ove aw | Ti. Volunteer for campaign eated activities, incuding phone barks, event Sovramce, Mllngs, cinvasSI, Seven o any Schr acy Shak advances a mai of condones To, Have you evr been convicted ofa felony fo WhGh you have not received ater: () 3 pardon; or 1) am order of naman ove fe ottense Date of Conviction | _ County of Conviction | _ State of Conviction 15. ve you aware of ay oer formate tha you aleve may asst te Ec Commision 1 80s vou Concern Your Compance with th State Government Eies Act? Cves GAs 1fyes, pense provide tha information below. The SEX and any attachments, excluding the Confidential Form, are public records. Page sor 10 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. 1 have not transferred, and wil not transfer, any asset, interest, or property for the purpose of concealing it from disclosure hie retaining an equitable interest. 1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding Unemancipated Children are public records. Ihave read and understand the following statutes: N.C.G.S. § 1634-191. Concealing or falling to disclose material information. Afiling person who knowingly conceals or knowingly fais to disclose information that i required to be disclosed on a statement of economic interest... shall be gui of a Class 1 misdemeanar and subject to disciplinary action under G.5. 1634-415. N.C.G.5. § 1634-192. Penalty for fase information. Ailing person who provides false information on a statement of economic interest . . . knowing that the information is fale is guilty of a Clos H felony and shall be subject to disciplinary action under G.S. 1634-415. 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 tru, correct, and complete to the best of my knowledge and belief. affirm under penalty of perjury that the foregoing is true and correct. E Yo Jf Signature Bate Printed Name X Submit signed, original documents only. Do not fax or e-mail this form. The SEX and any attachments, excluding the Confidential Form, are public records. Page 10 0f 10

FRY, NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY 78 = ELECTIONS AND ETHICS ENFORCEMENT Date Received: el 2018 STATEMENT OF ECONOMIC INTEREST i MAAR 13 P27 919-814-3600 wn. ncsbe.gov/Ethics/SEL necked ir comogion Rm] 2] “THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL YOUR SEI FILING OBLIGATION TRIES py” or mee ee Supp. Sent Doe w_ Supp. Received Ore nerd in dusbase oy ___ FILER’ NAME (FIRST, MIDDLE, LAST) A [oer [toe — [oomerewons 0 [oeme | Redicea | Rs Boards on which yo re serving or are being considered LEGISLATOR (Speciy House or Senate) oof mnt fmt ares ede yur ousehold? es Ono When usea throughout tis form, the ter Immediate family includes your spouse (unless legally separated. It also rs of your een Tami (yoo ond your 50uAss children, Srandchldren, pares, Srandparents, and lng, na th Spouses ofeach of thos parsons) whe reside In your household. othe fll name of all adults 3nd emancipated minors n your household. A minors a chd under 18 Years od Hnars are reancpore by marrage, aniSTment nth US ilar, o cour crdr for emancpation: FN EMANCIPATED MINORS ‘Business The SEI and any attachments, excluding the Confidential Form, are publc records. Page of 10 EE Bat ONLY the Iniials of all mermancipated minors n your household below. A mir is a child under 18 years od. Note: You must list the full name of each minor child on the Confidential Form available at the end of this document. INITIALS FOR NATURE OF UNEMANCIPATED ‘Business I I A EN PROPERTY INTERESTS 1. As of December 31, 2017, did you, your spouse, or members of your immediate family: Hens an owners interest In North Colina realestate (Including your residence) with 2 market value of $10,000 or more? Wes Ono “owner of Real Estate| 9% Ownership Interest | Location by City i basd and wife | 100 Surhield Johncty 8. 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? ves fo Name of Lessor Name of Lessee | 1 Real Estate, Location | If Personal Property, Renter) oy city & County Describe. 2. At any time during 2016 or 2017, did you, your spouse, or members. of your immediate family sell to or buy from the a personal property with a market value of $10,000 or more? Oes No amootvummer | emeaiseler | tweotrropery | The SEE and any attachments, excluding the Confidential Form, are public records. Page 20110 ee’ Ll ule. ,-k- pfo mmm 3 he of December 21,2017, 0 you, your spouse. or members of your medal family own any of the follwing financial Interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY. A. Stock in a publicy owned company? Ses Ono So ay ToReress Tn 3 WH Tid vestment fund (nuding mutual funds regulated investment Dt eran or deterred compéntation pans) f: (1) the fun Is publicly traded or ts assets are widely ae Oar vou nor an immediate arly member are able to Ontol the assets held In the mutual und, vem company, o pension o deferred compensation pan. [ owneroftamersst | FullNameof Company (Do not use a ticker symbol) fo Ad besa end wife. Bank of Avena a Stock Optians na company o business? aves fe peamste Gm Inteats 2 non-public ounad company or business enty (Including Interests in ole propretcrships, eres, Jor ventures, hed ably companies, med lablty partnerships, and Elcely ned corporations)? [ives fo 1°No." proceed to question [CC owerotimeex Name of Company or Business Entity C (2). For each non-publicly owned company or business entity (the “primary company") identified in question oa eee at he ames of any other companies o business entities in which the primary company rns vecors or €quly ares valued at var $10,000, if known. on-Publicly Owed Company or Business Entity | _ Other Companies in which the Primary Company (the primary Company) “Gwhs Security or Equity Interests The SE1 and any attachments, excluding the Confidential Form, ae public records. Page 30f10 I Ie (2) IF you know tht amy company or busines entay sted In 3.C or 3.C(1) above has any mteril business eines contracts with the State of North Caran, o is requited by the State, provide a brief Gescription of hat business activity. escripion of Bess Actiy with th Ste oe of Pacimber TL_20L2, were you, your spouse, or members of your Immediate family the beneficiaries of 2 vested ae 7 $16,000 or more that was created, established, o controlled by you? Do not list assets held in blind trusts. ‘See 2017 SEI Heloful Tips for the definition of "Vested Trust” and “Blind Trust.” Ove @ho Se of Dacha 31.2012, 4 you, your spouse, of members of your immediate family have labilies of $10,000 or ‘more, excluding the mortgage on your primary personal residence? ‘Examples include credit card debts, auto loans, student Toane, personal oans and intre-fomiy debt. Bes Oto ‘Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) Individual, etc.) List each sues of Income (nat specific amounts) of mare than $5,000 received by you, Your spouse, or members of your immediate family during 2017. Include salary, wages, “state/local government retirement, professional fees, TO ania Sental come, business income, and othr types of income required to be reported on your State and federal tax returns. Do fat include income received from the following sources: > capital gains » Federal government retirement > Military retirement » Social security income/SSDT Recipient of Income Type of Type of Income Business/ Industry C11 nod no reportable come over $5,000 n 2017. Albert Atel To. EER ES [Suarcra) Dept. [REREEENS Fob The SEX and any attachments, excluding the Confidential Form, are public records. Pages of 10 —— a PROFESSIONAL AND CIVIC RELATIONSHIPS 70 Daina 2017, were you, you spause or members of your Ipmedite fom a director, officer, governing board To) DUI 20LZ, Me racer, or rested obayit of a nonprofit corporation of arganiaton operating In the State of North Carolina primarily for religious, charitable, ‘scientific, literary, public health and safety, or educational purposes? Dives fo - 16 "No,” proceed to question 8. 5% ro et Sate boards or nies, or enties creed by 3 polial subdson ofthe State. > Be nt st organizations of which you ae a mere member. Wie Her Position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization 70) Ie nonprofit corporations a arganzaion ted above do business wih the State of North Carola o receve Te amet descrpton of ne nature of hat busines, known or with which due dllgence could Teasonabiy be know ‘Name of Nonprofit Corporation or Organization Describe State Business or State Funding Cone or ot Known S. During 2017, Were you, your spouse, or members of your immediate family a director, officer, or governing board EL heaton, o dvocacy ou wih an Interest in maters ver Which your 3gecy or bord may Toe Jursdichon? ives CN §fegiatoudiia fcr - You are no require to complte this esto ou re fing because or or Jucilofier of you are fing 5 an apple t thas offices. + 00 not lst organizations of which you are oly @ member (no serviog In 3 leadership roe). ‘Name of Society, Organization Leadership Position or Advocacy Group (Director, Officer, Board Member) he SEE and any attachments, excluding the Confidential Form, are public records. Page's of 10 I ——— SESS SSSA SC eo ah aga a es WR AR vars soc Whee va os mehr of you {edt ee er ropa o amber o anager oof ECHTI 31, 2012. Namaatponon | weimionnipto rier | Wameotcompary | __Roleatpenon | ST vo now omy compan or es ny ed (0) Shove 1d any Tater business desing o a a ee cari o wa eguinted he tte oof Decemr 31, 2017, provide 3 wos of te busine ct ame of Company o Business Enty esaiption of Business Acti with the tate fbr spotcaie (ho entities tte on #59) Fry r—— ves ON fail ffcar/sate attorney Ye’, haces ctegry of egal representation which you th aw fs WA whch you ar sf as aed legal fees of more than $10,000 during 2012. nominative Dama carports comet I Decedents Estates [Ep — Dtrrance Dtabor toca Government Rest propery secures oe Tort notion (cng Cutis Regulatan ~~ C10ther category nt tes. prion te soi you a Touma rfessonal Gar han an alomey) o dd Yau prove contig ares ere Fo ee on for when you cared o were pid aver $10,000 ove flo he 55k and any attachments, excluding the Confidential Form, are public records. page sor10 EE 12. Are you or your employe, your spouse or members of your immediate family, or thelr employes current: Lense by the State boar or employing ent with which you ar o willbe associated or + Regulated by the State board or employing entity with which you are or will be. associated or ka stots oe St vr employing entity with which you ae or wil be associated? ives Cho. Wfegislatorucica Officer - You ae no required to complete this question f you are lng because fe gator or 3 ical ofer (ual afer s dein in the SE Helpful Tis) or you Lo fing 0s 3m appotes ta hase oes. Name of Porson Name of Employer Type of Relationship if sppticable) (Licensing, Regulatory, Business) 13. you, your spouse ar a meer of you [madi omy currently reistered a5 a abby or Gpbyst princi) oar at 2 Soch whi he 12 morits receding your 80g of tis far? Oves #fo Lobbyists Principal Date of Registration Regiwation | "Expiration ‘OTHER DISCLOSURES “4. During any calendar quarter n 2017 (6 oly he ime period afer you were appointed, employed or fled or were Raninated 2» candidate), di you receive any ais" exceeding $200 per quate from person o oup of person acing together, and hen noth you and thse person(s) were outside North Carolina at the time you accepted the gs), and he is) ware given ander circumstances hat wou 65d reasonable person to conclude that they were given for Cota? 3 Ove whe > Do not report gifts given by members of your extended family. rt report gif tht nave previously been reported by Yau t the Department of the Secretary of Sate an the C0 pense Rape for Exempted parsons” en) ad We ull he SEX and any attachments, exciting the Confidential Form, are publi records. Page? of 10 55. Duro 2012 (out ony he ime period aRer You were oppante, eplayed, o led ar wers nominated 23 3 cade) aii you + cept a schaarship” exceeding $200 rom a person or group of persons acting together and those person(s) were outside Noth Carolina and the scholarship wa relted to your public postion? A “scholarship” isa grant-n-aid either direc or Indirect, to'attand a conference, meeting, or Smilar event, Including tuition, travel, KaBing: meats, and Ser Siar expenses. Eve Co ffl ocr You re ot reuired 1 complet hs gestion yu re cil fo youre ios 2 dios acer apps. > 00 not report gifs that ve previously Been reported by ou to the Department of the Secretary of State n the SE perce Raper To Exampicd Peon > Legislators ar na required report scholarships pad by a nonpartisan egsative organization of Which the feisiator or the General Assembly Is a member or paripant or 3 ate of that organ zation Date of ‘Name and Address of Donor(s) schaiarahip 16. Were you appointed o ar you being considered for an appoint to 8 covered board by the Governr o anather Counc of tate members Council of State members are: » Govemor > Lc Governor » Secretary of tate » State Auditor » State Treasurer > Superintendent of Public Instruction » Atorney General > Commissioner of Agriculture» Commissioner of Labor » Commissioner of Insurance ves iff 1 "Yes", lst al contributions you (NOT immsdiata family members) made during 2017 with a cumulative otal of more than $1,000 82 the Governor of ther Councl of State memisor whe Sppoinied you. > Contrbutions ar defined in N.C... 163-278.6(6) snd include, but are not mite t, “any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever,” Lp ome | aman | Contributed to No comrvutonts) with » cumulative total of more thn $1000 The SEX and any attachments, excluding the Confidential Form, are public records. Page serio 17. Ave you an appointee or prospecive appaiies a. the head of principal state department (e.3. cabinet secretary) appomted by he Governor; or 5. North Coolna Supreme Court Justice, Court of Agpeats, Superior or ite Zour Judge; or 2 member of any of th folowing boards: + ABC Commission © Coastal Resources Commission © State Board of Education Hes Ovo © State Board of Elections + Division of Employment Security I Wo” proceed to + Environmental Management Commission Question 18. © Industria Commission Human Resources Commission * Rules Review Commision * Board of Transportation © UNC Board of Governors * Utities Commission * Wife Resources Commission G.I 0, were you appoied a ar you being considered for sppomtment to that | (Ives Ne PUB BESO 8 Counc State memoar? Counc of Ste members are 19180 | 1 ong praceed to question 16. ¥ lis If 0, you must indicate whether during 2017 you (nt Inmediate arly members) engaged in any of the following aches with respect to o on behalf of | he candidate or campaign committe of ie Counc of State memer who © | 2ppainted you to your public postion: Ove Ono i. Collected conrbutons from multiple contributors, too possession of such lip Contrbutons, an transferred or deIered hoo colested Contributions to th candidate or comm tse? Contributions are defined in Gestion 16. i Hosted » fndrarsar at your residence o place of business? Ove Oe 1 Volunteered for campalgn-relate sctvies, which include, but ae ht Imted 10, Dhan banks, event assistance, malings, camassing, sunveyng, o any ther acuity that advances the cAmpaGn of a condces 16. Have you ever been convicted of a felony or which you have not received ster: () a pardon of innocence; o (1) an order of expungement regarding that conviion? Ove fo offense ate of Conviction | _ County of Conviction | _ State of Conviction 19. Are you aware of any other information that you believe may 355s the Sate Ethics Carmmision in advising You Concerning your omplance withthe Stat Government EHS ALS ves fo ityes, please provide such information below. The SEL and any attachments, excluding the Confidential Form, are public records. Page sof 10 aff that the information provided i this Statement of Economic Interest and any atachments hereto are true, complete, and accurate o the best of my Knowledge and boll. als certify that | have not transferred, and wil ro transfer, any asset ners, or property for the purpose of concealing i from disclosure while retaining an equiabl intrest 1 understand that my Statement of Economic Interest and any attachments o supplements hereto (withthe exception of the Confidential Form regarding Unemancipaied Children) are pub record acknowledge tht | have read and understand N.C.G.S. 138A-26 regarding concealing or faflng to disclose matecial information and N.C.G.8. 138A-21 regarding providing fle information: § 1384-26, Concenling o alin to disclose materia information. A fing person who knowingly conceals or knowingly fis o disclose information that required be disclosed ona iaiement of conomic ierest unde this Artie shall be guilty ofa Class 1 misdemeanor and hal be subject Todiscipiary ction under GS. 13845. § 13827. Penal for fs information. A ling person who provides fle information on statement of economic ners: a required under this Article Knowing that the informations fle i guilty ofa Clas H lon and shall be subject to dis pinary action under GS. 133A45. Signature tp=1ELY Albert A. Corlete) dv. Printed Name Submit SIGNED, ORIGINAL documents ony. D0 no fax or email this form. The SEE and any attachments, excluding the Confidential Form, are public records. Page 1001 10

(7. NORTH CAROLINA STATE ETHICS COMMISSION | [eee Date Received U4" 2017 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM A Checkes tor tompreea zx ns THIS ENTIRE FORM MUST BE COMPLETED TO | scanned ote FULFILL YOUR ETHICS FILING OBLIGATION ANS [A FILER'S NAME (FIRST, MIDDLE, LAST) eT He Ted Last Name | sur Mla Andy | Ie Adda 1 Andy oH Jr. REASON FOR FILING (COMPLETE ALL THAT APPLY STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/CONMISSION (Lis the complete name of al Sate boards on which you are serving or re being considered) JUDICIAL OFFICER (Speciy Office) LEGISLATOR (Speci House or Senate) Tinargeney Dihvict (ow Judy SE AFFIRMATION affirm that the information provided in tis Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowizdge and belie. also certiy that I have not transferred, and will not transfer, any asset, Intarest, or property for the purpose of concealing it from disclosure while retaining an equitable interest 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Chilcren) are public record. acknowledge that I have read and understand H.C.G.S. 138A-26 regarding concealing or fang to disclose material information and N.C.G.5. 1384-27 regarding providing false Information 5 1384-26. Concealing or failing to disclose material information. A fling person who knowingly conceals or knowingly ais to disclose information that is required to be disclosed on a statement of economic interest under tis Arice £nai be gulty of & Class 1 misdemeanor and shal be subject to Gisciplinary action Under G.5. 136A45. § 1384-27. Penalty for fase Information. A fling person who provides alse Information on a statement of economic interest a required under this Article knowing that the information 1s flse 5 Guy of 8 Class felony and shal be subject to disciplinary action under GS. 1384-45. I hereby affirm that I have reviewed my most recently filed 2016 Statement of Economic Interest and that as of December 31, 2016, my responses continue to be true, correct, and complete to the best of my knowledge and belief. Wi Rares ENTE) ature aa Finted tame | Submit SIGNED, ORIGINAL documents onl. Do nat fx ar e-mail tis om. _ J This entire document is a public record.

, NORTH CAROLINA STATE ETHICS COMMISSION [ores t & 2016 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM ! % Checkedfid chitin F423: 07 THIS ENTIRE FORM MUST BE COMPLETED TO | s.ynnea _ Date, . ILING OBLIGATION FULFILL YOUR SEI F) {J — Sewi2za ews wave sor, wovie, ast — — rte |r ms wade name | Cesveme sume | Alioect L Andy Cacti 1 Je. | | REASON FOR FILING (SELECT ALL THAT APPLY) ) ~ | CJ STATE GOVERNMENT JOB (Please specify the agency for | [] BOARD/COMMISSION (Please list complete name of ali | which you work or sre being considered State Boards on which you are serving or are beng a Sahih — Ladi bili Aud wacky —t — os suid hihi A, 1 Crogsocy Dedeicbad del | AFFIRMATION affirm that the information provided in this Statement of Econamic Interest and any attachments hereto ar true, complete. and accurate to the best of my knowledge ond belch | also certify that I have nt transferred, and will ot transfer, any asse, interest, or property for the purpose of concealing from disclosure whi retaining an cautabie terest. 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of | the Confidential Form regarding Unemancipated Chidren) are pubic record acknowledge that | have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material | information and N.C.G.5. 135A-27 regarding providing fase information § 1382-26. Concealin or aiing to hsclose materia information. A fing person who knowingly conceas or knawinaly fais to disclase Information tht s required to be disclosed on 2 statement of econamic terest under ths Aric shall DE QuIky of a loss 1 misGemeanor and shal be sonjoct a icipinary action under 6.5. 135A 45. 5 1383.27. Penalty for fatse information. A Hing person who provides fase information on a stetement of ecanemic interest as required under this Adicle Knowing that the information is fols 15 uiky o a Class felony and shal be subject to dieipinany action under | G5 Sones 1 hereby affirm that I have reviewed my most recently filed 2015 Statement of Economic Interest and that os of December 31, 2015, my responses continue to be true, correct, and complete to the best of my knovwiedne | angbeller. V1 Agree } \s, >] Rie | Signature ~~ —— Gate Alek A Clore Tir | Printed Name Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. | This entire document is a public record.

NORTH CAROLINA STATE ETHICS COMMISSION Fm dfisfis HERTS 4 Ji 2015 STATEMENT OF ECONOMIC INTEREST finial NO CHANGE FORM FILER'S NAME (FIRST, MIDDLE, LAST) LLL M40 First Name Middle Name Last Name Suffix REASON FOR FILING (SELECT ALL THAT APPLY) [J STATE GOVERNMENT JOB (Please specify the agency for | (] BOARD/COMMISSION (Please list complete name of all ‘which you work or are being considered) ‘State boards on which you are serving or are being | considered IDICIAL OFFICER (Please specify the office you hold) | [J LEGISLATOR (Please specify House or Senate) AFFIRMATION 1 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 beet. Talso certify that I have not transferred, and wil not transfer, any asset, Interest, or property for the purpose of concealing it from disclosure whi retaining an equitable Interest. 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 pubic ecoro. acknowledge that | have read and understand N.C.G.S. 1384-26 regarding concealing o falling to disclose material Information and N.C.G.5. 1394-27 regarding providing fale Information, § 1384-26. Concealing or falling to disclose material information. fling person who knowingly conceals or knowingly fails to disclose information that Is required to be disclosed on a statement of economic Interest under this Artci shall ba guilty of a Class 1 misdemeanor and shal be subject to disciplinary action under G.5. 138A-45. § 1384-27. Penalty for fase information. fling person who provides false Information on a statement of economic interest as required under this Article Knowing that the information i aise is guilty of a Class H felony and shal be subject to disciplinary action under GS. 136A45. I hereby affirm that X have reviewed my most recently filed 2014 Statement of Economic Interest and that as of Decombar 31, 2014, my responses continue to be true, correct, and complete to the best of my knowledge and belief. 2 Agree Yl 1 Printed Name Bate Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. Signatur This entire document is a public record.