Alissa "Sadie" Weiner

STATE ETHICS COMMISSION For stat use only (Zr, 2025 STATEMENT OF ECONOMIC INTEREST] .. : Fan) Date Received: oo IVED Wg Please review carefully and confirm San & that all questions are answered. : Incomplete SEis will not be accepted. ETHICS COMMISSION [prenx [FirstName | WiadioName | tasthame [sum | [| Alissa LL Twi [1] [ComontEmployer ____ — Jobvwe u ‘Reason for Filing (Complete all that apply.) State Goverment Employes o Filing Post Service | List Name(s/ot Al atoBoards on Which You Are Serving Specify agency and position: or to Which You Are Being Appointed Aone Ove =f (Govgmor r 1 Poston - Woe sped Vout Garry Serving a3 Judical Geer or Ping Post | Carron Servint 23 Logltator o Filing Pos Sori of Sonics or 2s an Appalntes (Spocty office ae an Aopaintee (Speci House or Senate) Eg One @8) enmoctate tami nchudes your spouse (umes legally separated) and unemancipated minor children (under 13). aie Incustes momvers of your extended farmly (rout anh your spouse's chidrom, grandenldren parents Granparants, and sings and tne spoueos of so5h of thas aceon who aside in your houschold Wye, ot the all mame of ll mmeciats fry members residing fn your hovaohol. List aly initiate ofnemancipated minors under 18) in sction'S below nd ful names on-Confidonia For at th ond of SEL" Immediate Family Member] _ Relationship | Employer sobTite | Nature of Business Fn oy Spf foi athe The SEL and any atachments, excluding the Confidential Form, ara public records Page tor 1 PTT WOT pr i eft erat atte hl oo Goer Fem at nan 55 ‘Unemancipated SR " me poe—— my mp rm «erent —— Corel ote dye en 10000 Wve Ono ocriony Com J ST OYes Xe Tr SE TE ne rT ee Ove NNo ameorpummr | emotes | western | 5 nt ary sence axcin ho Coden orm, ce plc records. rage 20110 [Rives Ono Tr eT ne ELS are got on ns i I [CC ownerormersst | Full Name of Company or ticker symbol Rams of arpa or Tear EE Tr Dives Clo IF "No proceed to question 4. [ owworimmesr | Nameof companyorousemsemiy | I A RN SS TT ee SE Ce a LLL LC re TT re —— ee a ET ewe, Description of Business Activity with the Stata EE PT Pm I pe Te A ey [arms 27 Adee Trae esiton ft Trane Vou ntsony othe Trt_| IE ee Sh ee SR SOO res Ivo EL a Ss I ———————— CE SB A Ee rn a Irion crmslivers that vou may have already listed in response to other SET auestions. SLL De oan Louvre, o Shab neti: CEL iio ne SR Fett hmpstmn ST I. Professional and Civic Relationships a Se er ty ee Se te mr Cy So, nr Yes [INo - IF "No," proceed to question 8. a hh. - En | pepe Fain. ee Be lmao Name of Nonprofit Corporation or Organization | _______Describastate business | EE TT ET EE nt ee ed Sy er be Er o sito [J Lagisiator/ Judicial Officer - You are not required to complete this question if you are filing solely soon rt sete cr ht fr 007 a SP i am ee Ter [| Smee | neti Eo ot ry crn cin Cont Form, re J LT [Semeotranor | wetommptorier | ameotcompeny | samira | roceed to qustndo. RS I RA SALA ASA ni sh Be oerpion of uses e wi h ts gr Dyes Ro [Judicial Officer/State Attorney (In House Attorney he gm wat ste on i Sh Coma Sy a So EA rt | Toman Gur J i Sin ore aris || crerty | mem porivon Br ei epee a Ee eae BON TY CS IY = vs at any mat, chlo the Gon frm, rs ue rs. ransatio ves ne [) Legislator/Judicial Officer - You are not required to complete this question If you are filing because i fling of this SEI? [Yes Ke a | men i —— 3 EE eon ee es em | | ripen aerosol aran Ee se Rpm Ltn — Sm Des He [Judicial Officer - You are not required to complete this question if you are filing sey as a judicial rea == 16. Have you been appointed or are you being considered for appointment to a covered board by the Governor of Hivos ves, Fe EE LR Ee CI EC I... De Pr ype p—rpppep—pe—— Jism dan FC —— ine a member of any of th ling board: Oves ae etm ver pls to quston 15. po * Sasomd often Y Swmtemiosesien © vin of payment securty I © Sniutlcommisdon mn Reston Gomis > Reber pA D Crmet— © Wit Resmress Commision Pep —— ST p— ev—Y fT eT phe or proceed 10 question 1. TET — Laan aw agp roti all coco, foe npn gn ER RI Bol gh A er. nen = roe = yoo renters or pct EST [oe owe | PRET —————— Fri ibis Mr Berg Da een pa ons? To Tore To ve ean Some olor or yo hv ok reed er (pra or (1 a order of vee Jane [ oreme owe otcowicion] Goumyof conviction | _ tate of conviction won ee aR A yo Bee See Son 8S You A mean os Coven Spe? Cover ioe ye, ples provide a formato blo: The SEI nd any attachments, excluding the Confidential Form, are public record. Pegesor1o ‘atfiemation he formation provided nti tatamant of Econo ners and any aachmens ar rv, complet, and sccite Te Se af iad and bat. have ne transfered, and wil tran, any ast, ret, or propry for th papose of concealing fom noes va raring an scat are. understand tha my Statement of Economic test and any attachment except fo the Confdantl Form regarding Unarancpeted Chien re publ records. hava red and understand th follwing satuts: JC.G.5. § 1382, Concaaing or ffl to discos material infomatn. fing parson who knowingly conceal o knowingly alt disclose formation that i equred tbe dicossd ee inl ba ly of 5 Co 1 mademeanor nd subject t dispinary fibres ILC... § 1364-27 Peak for als information, fing prs ih provides ls Information an» statement of sonar ners. knowing that the rg a eine fon and shal bo Subs 5 dicplnary aon und G.. 1364-35. aff under penatty of perjury that the foreging true and corect (AAI 415, Siomatire 3 Primed Name Submit signed, orginal documents ony. Do not fax or e-mail this form. the SE1 and any attachments, excluding the Confidential Form, ae public records. Page 100110

STATE ETHICS COMMISSION For Staff Use Only GER 2024 STATEMENT OF ECONOMIC INTEREST wr { P) ate kecelRE CEIVED ay J Please review carefully and confirm R15 204 that all questions are answered. h Incomplete SEIs will not be accepted. NC ETHICS COMMISSION iors are (ir, ade ce) [ore rirstome [wisstamame — Jimstmame oun | [ [isa [ [wer [| TE 1. YE TE EE Se Gove it romero iat Sous a Wh Vou re Servi or ovation: i vou Ae Sang Aspnes [oro ofc d voor | Fea We SSR Var Dir. = Brioma friars Currently Serving as a Judicial Officer (Specify office) Currently Serving as a Legislator (Specify House or Senate) revo CoE ors Severed ST OE Er Lr Como: ar Council Satay Chie to RD ary meats Tay aS ce Tee our Fold ee One meds family” Include your spouse (ures legally separated) and unemanciated rior chlren (under 16). 1t gist Megane ipa apis Ro Sr Sings ane ps fac of toe rons) whe resin vourhausehd. ye, Ist he fll ame fal immediate family members residing n your household. “Liston ils of unemancipated minors (under 16) nsecton’8' below rd me on Seen For wt end of Sr [mmeciate amity amber] Relationship | employer | dob Title [ Matura of Business| The SEL and any attachments, excluding the Confidential Form, are publicrecords Page 10t2 El a [ow laid | qa—ot [| I EE AS I EE EE EE I EE EE Res ONe [obispse | 1007 | Valen | Woe | [17° 1 in a I ll il B= al I EE EE I EE EE A omorrummr | wanes | votre | rr © rr © | rrr I EE EE 3 As of December 31, 2023, id you or any members of your immediats family wn any ofthe allowing fnancil nterests Valoed t $10,000 or more? A Stock in a publily owned company? Ros Oto List the name of each company in which you own holdings of $10,000 or more. Do not list the number of shares, options, or the value of your holdings. » Include stocks held individually or in a portfolio managed by a financial services company. > Do nat lst interests in a wicely held investment fun (Including mutual funds, regulated Investment companies, or pension or dafared compensation plans f 1. the fund 5 publicly traded, or ts assets are widely diversified; and 3. nether you nor an immediate arly member ae abl to contol the fund's assets. [_ ownerofmmterest [Full Nameof Company or ticker symbol Lawn Waa A phalek 5. Stock options ina company or business? Oves five ori SRDoEn Full Name of Company or Hiker symbol Trterests Tn 3 nonpublic owned company or business ent These Include erests n 91 partnerships, limited partnerships, Join ventures, limited labilty companies, ited aby partnerships, and closely held Hi¥es CINo-If "No," proceed to question 4. [ owerotmeres | Name of Company or Business Entity [Zamwwowa | fy Stoke C(0). For wach company or business any dented In question 3.C. (he “primary company”). please I the raed fay other companies or business entitles In which th primary company owns securities o equity Interest Valued at over $10,000, known. ‘Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the Primary Company listed in 3.C. ‘Ouins Security or Equity Interests The SEL and any attachments, excluding the Confidential Form, are public records. Page 30f 10 Name and Address of Trustes Vour Relationship tothe Trust — Jha Relrement beneie; or Social Securty redrement, survivors, or dsabilty benefits, = Professional and Civic Relationships : on MA yvonne ON (ho mde <¢ Govan great (Yes No Cagsator ucla Officer - You are nt required o complae his question I you ae ling solely [fer Coto Wo proces to qsstioni. At Tov negligence) 12. Ar you or your employer, or any members of your immediate family, or ter amployerscuranty: - lcansed by the Sate board or agency ith which you ae o wil be ssedatedor «regulated by the State board or agency with which you are or wil be assocltedor «Ina busines eatonship vith th State board or agency ith which you are or wil be associated? Yes flo Lageatorudicial Officer - You re na racuira to complet this question f you are fing because Vou re legislator o dill oficr or 4. candidte or points to these offices. Homewsr, you ara ai ling 2 8 mambar of 3 Sats board or 25 » State employee, passe answer ves oro’ to ths question. Af “yes” provide the folowing information. Name of Employer Type of Relationship it applicable) (Licensing, Regulatory, Business) 3. Hove you or a member of your immediate formly boa registred o a (aby it within th 12 manth preceding your filing of this SEI? [] Yes Tne 16yes,” provide the follwing information. Name of Lobbyist Date of Registration Registration | Expiration Other Disclosures 14. During 2023, aftr you ware sppontad, amployed, o lad or were nominated a2 candast, aid you + recive any "gf(s) exceeding $200 par quarter from a parson or roup of parsons acting together, + when both you and those parsons) were outside NorthCaroln, © under circumstances tht wad esd a reasonable parson to conclude the gt wera given or abbying? To answer Yes, ll tree conditions mus apply. ove Yio > 00 no report ft given by members of your extend. > 00 no report gt yu hve previously reportad on the “Expense Report for Exemptadpersons.” Si Name and Address of Donor(s) | Describe Item Received | gn The SEX and any attachments, excluding the Confidential Form, are public records. page 70 10 15. During 2023, ater you wera appointed, employed, o fled or were nominated a a candidate, dd you + accept a “scholarship” xceading $200 related to your public position from person o Group of orsans cing Together + when those person(s) were outside North Carolin? To answer Yes, both conditions must apply. A"scholarship*isagrantin-aid,sither directorindirect, to ttendaconfarence, meeting, or similarevent, including travel, lodging, meals, and other similar expenses. ves i uc Ofer ou srt rgradto compute ths quest fy rs ig youl offcer or 3 Judicial afr candidate or sppolntes. > 00 no report ts you have previously report on the “Reportable Expenditure Mada by PersonExempted.” > Legislators are not reuird to report schlarships pad by nonpartisan legislative organization of which th egislaor or the Assembly s member, paricpant, orafiate: Date of Name and Address of Donor(s) Scholarship 6 Rave you bean painted o 3 yau being considered for sppantment to covered board by the Governor or 3 member of the Counc of Sate” Council of State members include: > Governor > Lt Governor > Secrstory of state > State Auditor > State Treasurer » Superintendent of PublicInstruction > atomey General > Commissioner of Agriculture» Commissioner of Labor > Commissioner of Insurance Nive Nivo 16 “Vas, list all contributions you made in 2023 with a cumulative total of more than $1,000 to the Council of State member who appointed you. Do not includ contributions from immediate family members. “Contributions are defined broly In .C.G.. 163-276,6(6) and Include any advance, conveyance, deposi, isibution, transfer of funds, Ioan, payment, gi, pledge or subscription of money or any fing of value whatsoever. Tio conrbution(s) with 3 cumulative tata of more than 1,000 The SEE and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 the head of» principal ats department (9. abet sores) ppd BY 5. Noth Carlin Supreme Court sie; or Court of Appa, Spar, of Shes cot sero c. 8 member of any of the following boards: [Yes He asc commision Nor” laced to question 5. © Sue Boma afeaucton © Ste Bord alactons © Own of Employment Sour Rp — © industria Commision T Is © Ries Ravin Carmi © saad Transporation © Chie Commission © Wide Resource Commission Ten were You append o are you aig coder or sppommert to tht | Yes Ie Portion oy Coun of Soa mamber? Noy proceed to uestion 5. pT —— Romp di pe Rd Compan cries of tha Counc o Sve mame whe sppOMASTOL: HE ——— ir SX al gh Se Conettons ta he condone or comes” © oes 3 riee you resenee or pe FOLIO [Ove ow | i Volitesred o ample ralted sett. nln hor bas i TS Tova Er Seem Some 73 fle fr hi yo re ok reed Wars (0 wor or om ro Ove Ye | otiemss J owteot comction] county of canvictian | state of conviction Fm — pe evo camphone wi ou Ste Sovran, Sov 8 ives No ifyes, please provid that formation blow. The SEE and any attachments, excluding the Confidntial Form, re public records. Page sof 10 Affirmation The information provided inthis Statement of Economie Inaret nd any tachment re tue, complee, and s<euate oth best of my knowledge and baler have not transfered, and wil no transfer, any asset, Interest, or property for the purpose f concealing t rom Gilosrs wht evan an squkable terest understand tha my Statement of Economic ntres and any attachments excep or the Confidential Form regarding Unemanciated ChIGran are publ records have read and understand th fling statutes: N.C.G:5. § 1384.26. Conceling or fling o disclose materia formation, A fing person who knowingly conceals or knowingly als to disclose information tha s required to b disclosed Gna Shamant of aconomic Inires shal ba Guy of a Class 1 demeanor and psec a GHEPUNBYY Seton under G5 13845. NGS. § 1384-27, Panay for fsa information. A fing person who provides false Infomation an a statement of econamic Interest. knowing that the Iformation 1 ai GUY of Cac ean a shall Subject 1 sciinany scton unde G5: 1364-45. 1 affirm under penalty of perjury thatthe foregoing is true and correct. [1% All |o4 Somature oa PASS Woe Printed Name Submit signed, original documents only. Do not fax or e-mail his form. ——————————— etc ceceett] The SEE and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

_ or staff se ony 7 STATE ETHICS COMMISSION —— {a 4) 2023 STATEMENT OF ECONOMIC INTEREST This entire form must be completed to fulfill your ethics filing obligation. Filer's Name (First, Middle, Last) he nr ™ Oke of Grovumor Dur. ok External Affnics Lommwni crhovs Reason for Filing (Complete all that apply.) Stats Government 100 (Spec agency and postion.) | Board/Commisson (List the complete names of al Sate Doards on which yo are serving or are being considered.) leoomars Ua Ded Extoreo pfs |__| Currently Serving as a Legislator (Specify House or Senate Peat Service Flr (Spec Ofice Fad Tn 207%, 6.3. Todas, legislator, disc attorney, or clerk of court.) Ro amy Immediate arly members reste In your household R Yes [No **“Immediate family” includes your spouse (unless legally separated) and unemancipated minor children (under 18). IE al includes members of your extended family (your and your Spouse's hidren, arandchlaren, parents, Grandparents, and sings, and he Spouses of 6ach of hose persons) who reside in your household. Lis the ul name of all immediate family members sing in your household List emancipated minors on separate form. Minors may be emancipated by mariage, enlistment in the US miltry,or cour order fo emancipation Zona Winoma_| Spoge. [Sof fy [owner |fuoder | Congutiig [7 1" | swig] = J he SET and any attachments, excluding the Confidential Form, are pubic records Page Tor 1 8. List only the initials of ll unemancipated minors in your household below. A minor is a child under 16 years ad. List the full name of each minor child on the Confidential Form at the end. Initials of Job Title Unemancioated Ten Towa | ona—o | Property Interests 1. As of December 31, 2022, did you or any members of your Immediatefamiy: A have an ownershipinterest in North Carolina real etate (Including your residence) with a market value of $10,000 or more? ves Ono Owner of Real Estate | 9% Ownership Interest | Location by City Location by County 5. lease o rent rea state o personal property to or from the State of Nort Carolina with a market value of $10,000 or more? Li pi Oves no Name of Lessor 1f Real Estate Location | 1f Personal Property, by City & County Describe 2. At any time during 2021 or 2022, did You or any members of your immedate family sell o buy personal property tor from the State of North Carolina with a market value of $10,000 or more? 3 Oves Who . I Type of Property fr] : Wiha SET and any attachments, exdiuding the Confidential Form, are public records. Page 2 of 10 [Yes [ONo [ ownerormmerest | Full Name of Company or ticker symbol B. Stock options in a company or business? ® Yes [No - If "No," proceed to question 4. €(1). For each company or business entity identified in question 3.C. (the “primary company”), please list the names, C2) 16you know that any entity listed in 3.C or 3.C(1) above has any materiel business dealings o business contracts with the State of North Carolia, of is regulated by the Sate, briefly describe that business activity. Name of Company or Business Entity Description of Business Activity with the State 4. As of December 31, 2022, were you or any members of you Immediate family the benefcaies of a vested trust with 2 value of $10,000 or more that you created, established, or controled? Do no st assets held n bind trusts. Definitions for “Vested Trust” and "Blind Trust” can be found on our website under "SET / SET Helpful Tips” hitps://ethics.nc.cov Oves [to Soveipton ofthe Teast |Your Ration to the rust 5. As of December 31, 2022, did you any members of your immediate family have labile of $10,000 or mre, excluing the mortgage on ‘your primary personal residence? Examples Include cri card debts, auto loans, Sudent loans, persona loans, and nta-family debt. Kes Ono Name of Debtor List Type of Creditor (e.g. "commercial bank," o_ "credit union,” individual," etc) Co town 6 List each source of icome (not specific amounts) of more than $5,000 received by you or any members of your immediate family ding 2022. Include salary, wages, sate/ocal government retirement Income, professional fees, honoraria, Interest, dividends, rental Income, business Income, and any othr types of Income required to be reported on your State and/or federal Income tax returns. + Attention! You must disclose salary or wages received from any governmental or private entity, including employers that you may have aiready listed In response to other SEI questions, + Dono indude income received from the following Sources: capital Gains; federal government o miltary retirement benefts;or Socal Security retirement, survivors, or dissbily benefis, «| Recipient of income Name of Source Type of Business! Type of Incame Industry C11 had no reportable income over $5,000 in 2022. Kuisan wane de Sula A yer sear | popu wllos | vue sie) ta. | Professional and Civic Relationships [CINone or Not Known 8. During 2022, were you or any 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 Ces No ClLegislatorucical Officer - You are na required to complete this question if you ar fing solely rg J I partner, proprietor, or member or manager of a fr raft business? | Semeotraren | nevtonip trier | vamestcompary | sestrenon | RE I I ERAS RR I EE EE EE I I EE I 1 1 1 State of North Carolina or was regulated by the State 2 of December 31, 2022, bify describe that ctv. rr I EE MEE SE SE NE. 10. Are you s practicing attorney? ; "Ves, check each category of legal representation n which you or the aw firm with which you are affilated has eared legal fees of more than $10,000 during 2022. [Administrative 0 Admiralty (Corporate [Criminal Oecedents Estates Environmental Otnsurance Otavor ~~ [0 Local Government: [OReal Property OI Securities OTax [0 Tortlitigation (including [utilities Regulation [Other Category negligence) 11. During 2022, were you a licenséd professional (other than an attorney) or did you provide consulting services Indvidualy or 2 a member of 3 professional association for which you charged or were pid over $10,007 Oves [no : ee Type of Business. Nature of Services Rendered —— i ; 1 The SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. Are you or your employer, or any members of your immediate family, or their 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 wil beassociated? (C3ves io 0 Legislator Judicial Officer - You are not required to complete tis question if you are fling because You are a legislator or a judicial officer or as a candidate or appointee to those offices. However, if you are also fling as a member of a State board or as a State 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 3s a lobbyist or lobbyist principal within the 12 months preceding your filing of this SEI? Oves Eno Name of Lobbyist Lobbyist's Principal Date of Registration Registration Expiration Other Disclosures 14. During 2022, after you were appointed, employed, or fled or were nominated as a candidate, did you + receive any "git(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 lead a reasonable person to conclude the gifts were given forlobbying? To answer Yes, al three conditions must apply. Oves fino P00 not report gifs given by members of your extended family. » Do not report gifts you have previously reported on the “Expense Report for Exempted Persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received [| mgm ‘The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 rire » Commissioner of Insurance 3 oh 1 “Yes,” list all contributions you made in 2022 with a cumulative total of more than $1,000 to the Council of| CT — comme CINo contribution(s) with a cumulative total of more than $1,000 17. Are you an appantee or prospective appoint a5: 2. the head of principal tae department (6.3, cabinet secretary) pomted by The Governor, o 1. North Carolina Supreme Court Justice; o a Court of Appeal, Superior, or Disc Court Judge; o .. a member of any of the folowing boards: Oves sie + ABC Commission 1°No,” poceed to question 16. + Coastal Resources Commission + State Board of Education + State Board of Elections + Division of Employment Security + Environmental Managemen Comission + Industria Commision + Human Resources Commision + Rules Review Commission + Board of Transportation + ites Commission + Wildite Resources Commision 4.10, were you appointed or ae you being considered fo appoint to that | (J¥es (No poston by » Counc of State member? a — If 50, you must Indcate whether during 2022 you engaged In any of the folowing acivies with respec t or on behalf of the candidate o mpg ommitie of the Counc of State member who sppoin ea you: {Collected contributions from multe contributors, took possession of such multiple” contrioutions, ond. anstered or delvered. those. collected Contributions to the canddate or commit? i. Hosted a fundraiser at your residence or place of business? [Oves One | i. Volunteered for campaign-related activites, including phone banks, even] asistance, mains, canvassing. Surveying, or ny oer sciviy that vances the campaign of candidate? 16. Have you ever been convicted of felony for whch yo have not receved other: () a pardon; or (1) an oder of Sxpungemens? Oves gw [oem | oateor conviction] County of Conviction | _ state of Conviction 19. Ave you aware of any other Information tat you beleve may ait the Ethics Commission in advising you concerning your compliance with the State Government EENS Act? ives EiNo 1fyes, pease provide that information below. The SEX and any attachments, excluding the Confidential Form, are public records. Page gor 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 will not transfer, any asset, interest, or property fo the purpose of concealing it rom disclosure while 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. 1 have read and understand the following statutes: N.CG.S. § 1384-26. Concealing or falling to disclose material information. filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and subject to disciplinary action under G.5. 138-45. N.C.G.S. § 138A-27. Penalty for faise Information. A fling person who provides faise Information on a statement of economic interest . . . knowing that the information is else is quity of a Class H felony and shall be subject to disciplinary action under G.S. 1384-45. L affirm under penalty of perjury that the foregoing is true and correct. AEA 4lu|zs Signature Date tissa Ake . . Printed Name ‘Submit signed, original documents only. Do not fax or e-mail this form. ee eee — /@@/ / mm The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

Fr staf use oy Grad) STATE ETHICS COMMISSION Date Received: UAH 2022 STATEMENT OF ECONOMIC INTEREST RECEIVED APR 18 222 This entire form must be completed to fulfill ‘your ethics filing obligation. NCETHICS COMMISSION Filer’ Name (First, Middle, Last) Pisa || [| Current Employer Ofhu A _covomor [Divedkor 4 Extomal Altans | Reason for Filing (Complete al that apply.) State Gavernment Job Specly agency and postion) | Boord/Cammissan (Us the completa names of ai State boards on which you ae serving or are being considered.) oneal's Oh “Diveskor Brkoma lows Senate) “are you 8 CANDIDATE for a covered lected office? | [If Yes, List Office and District/County (1 appicabe) (src, Supsrior, or Supreme Court, Court of Appeals, Clerk of Court, District Attorney, or General Assembly) Oves I ‘A. Do other immediate family members reside in your household? Nes Ono On this form, “immediate fami” inciudes your spouse (unless legally separated). Tt is includes members of your tended fori (you and Your spouse's hlcren,Grandeniien, parents, Grandparents, and sbings, an the Spouses oF cach of hose persons) whe reside In your household. ist the full nome of al adults and emancipated minors n your household. Minors are chien under 16. They are emancipated by mariage, nlissment in the US milkay, or court order for emancipation. Full names of Adults and | Relationshlp | Employer JabTitle | Nature of Business ‘Emancipated Minors i 20a Fi YOKE. SAL -Pal Owner | gl | Consol The SEZ and any attachments, excluding the Confidential Form, are public records. Page 10f10 8. List only the Inia of al unemancpoted minors In your household below. A minors chid under 16 years od. List the ull name of each minor child on the Confidential Form at the end. Initiale of ‘Unemancioated (ew Joa | wa—rt [| Property Interests I. As of December 31, 2021, 6d you or any members of your immediate fay: A. ave an ownership intrest n North Carolina real estate (including you reldence) with market value of $10,000 ormore? Res Ono [owner of Rest state | % Ownership tuterest | Location by city Losstion by County 5. Tease or rent realestate or personal property 1 o from the State of North Carolina with a market vale of $10,000 armors? Ores Kno If Real Estate, Location | if Personal Property, by City County Describe 2. At ory ime during 2020 or 2021, dd you or any members of your immediate family sel to or buy from the Sate of North Caraina personal property worth $10,000 or more? Oves Kno | emeorpuowser | Nemeorselw | Type of Property The SET and any attachments, excluding the Confidential Form, ae public records. Page20r10 Financial Interests. | 3. A of December 33, 2021, dd you or any members of your Immediate family own any of he following financial terests aioe ot $10,000 o mare? Lik sach company individually. A. Stock in a publicly owned company? Hyves Oo > Do ft et Interests na widely hid investment fund (including mutual funds, eguated Investment companies, or pension or deferred compensation plans) 1. th fund i publicly traded, o ts assets are widely diversified; and 3. nether vou nor ah immediate fami member are able to control the underlying assets. Owner of Interest Full Name of Company or ticker symbol ory — \pabek 5. Stock opions in a company o business? Oves fe Owner of tock Option Full Name of Company (Do not use a ticker symbol) “C Imarets In 3 non publ owned company o business entity? Thess Include terest In sle proprietors, . Tarmerenie, Ihe pornershpe, Jom ventures, mies aby companies, ited ably partnerships, and Cosa held corporations. [ves [No - If "No," proceed to question 4. [CT owerotmeres | Name of Company or Business Entity (1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the names of any other companies or business entities In which the Primary Company owns securities or equity Interests Vase at aver $10,000. f known. Nom Publily Owned Company or Business Entity | _ Other Companies in which the Primary Company (Cha primary Company) “Owns Security or Equity Interests iene or nat known The SEX and any attachments, excluding the Confidential Form, are public records. Page3of 10 C11 you know thet any entty sted in 3.C or 3.0(1) sbove nas any material business dealings o business Cofracts with the Stat of Narn Caron, or related by in Sa, rey describe tht business Sc. Name of Company or Business Entity Description of Business Activity withthe state None or Not Known 4 of December 31, 2021, were you o any members of your immedite fam the benefice of a vested rst ia vata of $16,000 o more hat you creat, etobbsned, a conrad? oot is asets hed in bin trusts. Defnons for Vested Trust” and “lind Trust” can be found on our webske der “Seis | SEI Hlpul Tips Mpa nego Olves He Nore and Address of Trustes Description of the Trust Vour Relationship to the Trust 5 a of December 31, 2021, id you any members of your immediate ami hve ables of $10,000 or more, exuding ne esgage on you primary personal resdences Example nse rest card dant, aut ans, sent 031, personal ane, and nr family de. Rvs Ovo Name of Debtor Type of Creditor (commercial Bank, credit union, niin ote) ASSO ur + 2004 Wintlows ommend bomk _ a List each source of Income (not speci amourks) of mare than $5,000 eceved by you or any members of your mediate family Gung 2033 Iniade Saar, wages, hte/oca sovemment reternt Income, professional (ec, Hora, nares, donde, renal income, bushes income, and othr ype required to ba reported on Ste and Teter to returns. =" Attention! You must disclose salary or wages received from any governmental or private enthy, Inching employers hat you may Pave already sted I response 1 other SEI questions. + Do not Include Income received from the follwing sources: Capa Gains; federal goverment or itary Fetement benefits soc securiy/S501 Type of Type of Income Blimess/ Industry 31h ro reportabe came ovr $5,000 n 2021. I i ER A EA The SEL and any attachments, excluding the Confidential Form, are public records. Page aot 10 Professional and Civic Relationships 7a). During 2021, were you or any members of your Immediate family a director, officer, governing board member, employee, independent contractor, or registered lobbyist of 2 nonprofit corporation or organization operating n North Carolina. primarily for religious, charitable, scientific literary, public health and safety, or educational purposes? Yes fo - 1 "No," proceed to question 8. > Do not lst State boards or entitles. > Do not list organizations of which you are a mere member. Name of Person Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 70). Ifthe nonprofit corporations or organizations sted above do business with the State of North Carolina or receive State funds, briefly describe the nature of that business, If known o with due iigence could reasonably be known. "Name of Nonprofit Corporation or Organization Describe State Business 5. During 2021, were you or any members of your Immediate family a director, office, or governing board member of any society, organization, or AGvocacy Group With an Interest in matters over which your agency or board may have Jurisdictions ves igo Distancia Offer -You are nt required to complete ths question you re filng sol because you are a legislator or judicial oficer or as a candidate or appointee to those office. However, If you are also ling as a member of a State board or as a State employee, please answer “yes” or “no” to tis question. If your response Is yes,” provide additonal Information. Do not lis organizations of which you are only a member and do not serve I a leadership role. Name of Person ‘Name of Society, Organization, Leadership Position or Advocacy Group (Director, Officer, Board Member) ‘The SEX and any attachments, excluding the Confidential Form, are public records. Pages of 10 9(a). List the name of each business with which you were associated where you or a member of your Immedate family was an employee, director, officer, partner, proprietor, member o manager 5 of December 31, 2021. | Nameofperson | Relationship to Filer ‘Name of Company Role of Person [No Business Associations [Zh Windovg | Spous Ky Stakes puopictes 9(6). Ifyou know that any entity lst In (a) above had any material business dealings or business contracts wit the State of North Carolina or was regulated by the State as of December 3t, 2021, briefly describe that activi. "Name of Company or Business Entity ‘Description of Business Activity with the State Het ‘applicable (No entities listed on #9a) 10. Are you a practicing attomey? ves No. 3udicilOffcer/Stte Atomey 11"Ves", check each category of legal representation in which you or the law fim with which you are affited has earned legal fees of more than $10,000 during 2021 0) Administrative 0 Admiralty Corporate 0 criminal Decedent's Estates Environmental Oitnsurance Dltabor tocol Government [Real Property Osecurttes OTe | Tort tigation (inclucing 0) Utlties Regulation [Other category na listed | negligence) 11. During 2021, were you a licensed professional (ather than an attorney) or cd you provide consulting services individually or 25 & member of professanal association for Which You charged or were pad over $10,007 Ove OM vermis er Te — ‘The SEX and any attachments, excluding the Confidential Form, are public records. Pages of 10 Ores Jo Cl tegisiator/Judicial Officer - You are not required to complete this question If you are filing because. ' ‘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 lobbyist principal within the 12 EE 15. During 2021, er you were appointed, employed, or fled or were nominated 5 a candidate, did you + accept a “scholarship” exceeding $200 related to your public positon from a person or group of persons acting Togetner, + when those person(s) were outside North Carolina? To answer Yes, both conditions must apply. Avscholarship” Is a grant: in-aid, either direct or indirect, to attend a conference, meeting, or similar event, Including tuition, travel, lodging, meats, and other similar expenses. Wes Fo Cuoco offer - You ae not required to compete this question you ae lng as Judicial officer ora Judea officer candidate or Sppointee. 00 nat report is you ove previously reported on th “Expense Report for Exempted Persons.” > Legisltors are not required to report scholarships paid by a nonpartisan feiltive organization of which the legislator or the General Resembly s 3 member, partcpant o ofate Date of Nome and Address of Donor(s) Describe Event Estimated Market Scholarship Value oars Dealaoa) (Pomenatic Gov WA 0 Pessuron ve 20 1325 | sk NW BN Shan DL 2005 16. Have you been appointed or considered for appointment to a covered board by the Governor or another Council of State member? Council of State members are: > Govemor » ut Governor > Secretary of state > State Auditor > State Treasurer > Superintendent of Pubic Instruction > Attomey General > Commissioner of Agriculture» Cormisiorer of Labor > Commissioner of Insurance Ove Je 1 “Yes, lst all contributions you made in 2021 with a cumulative total of more than $1,000 to the Council of State member who appointed you. Bo not include contributions from Immediate family members. > Contributions are defined broadly In N.C.GS. 163-278.6(6) and include “any advance, conveyance, depos, sriaton, transi of funds, oan, payment, Gf, ledge o SubseHpYan of money o anything of value whatsoever. [ome Tamm] Contributed to To contrbution(s) with » cumulative total of mare than $1,000 The SEI and any attachments, excluding the Confidential Form, are public record. Pages or 10 17. Ave you on pointe or prospective appointee as: a. the head of a principal state department (e.g., cabinet secretary) appointed by the Governor; or 5. a North Carolina Supreme Court Juste; a a Court of Appeots, Supsir, or Batre Court Judge or . member of any ofthe follwing bart: Oves io + AC Commission 1°No”piaceed to question 15. + Coastal Resurces Commission + State Board of Education + State Board of Sections + Division of Employment Securty + Environmental Management Commission + Industral Commission + Human Resources Commission + Rules Review Commission + Board of Transportation + Unites Commission | + Wide Resources Commission a so, were you sppoited or are you being corded or appontment to that | Oves [No postion by » Coun of Sate members iE nd | I 50, you must ndcate whether during 2021 you engaged n any of the 1 {Glowing actives with respec to o on bana of he candidate or campaign Committe of the Councl of tate member who appointed you: Collected contributions from multe contributors, tok possession of such multiple contributions, and transferred or delivered those collected | [JYes [No Contributions to the candidate or committee? i. Hosted a fundraiser at your residence or place of business? [Oves One | Ti. Volumecred for compaign-eated atts including phone banks, event assistance, maings, canvassing, Suneyig, ar any oir acy that | CI¥es (INo advances the campaign of a conddate? 15. Fave you ever been comitad of a felony for WAI you have not received ener: () 8 pardon; o (1) an order of expunament? Oves MN EE — Date of Conviction | County of Conviction state of Conviction 15. Are you ovare of any other information (hat you blleve may asst th Ethics Commission in advising you Conceming your compliance with the Sate Goverment Ens Act? Ives (No 1fyes, lease provide that information below: The SEX and any attachments, excluding the Confidential Form, are public records. Page sof 10 | Affirmation | to the best of my knowledge and belief. 1 Unemancipated Children are public records. 7 EE ——— ‘action under G.S. 1384-45. A fling person who provides false Information on a statement of economic interest... knowing that the | information is false is Guilty of a Class H felony and shall be subject to disciplinary action under G.S. 1384-45. | eft ander panty of priry that th orsging rv and core us gen, __2laifoa Tosa = a JR ————— Ihe Sk and a tachment xcs th Confident orm ar bl record. J

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 STATE ETHICS COMMISSION 2021 STATEMENT OF ECONOMIC INTEREST ELECTRONIC FILING This entire form must be completed to fulfill your ethics filing obligation. Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Ms. Alissa Weiner Current Employer Job Title Office of the Governor Communications Director Nature or Type of Business Public Affairs Reason For Filing (Complete all that apply.) State Government Job (Specify agency and position.) Board/Commission (List complete names of all State boards on which you are serving or are being considered.) Governor, Office of the - Communications Director Judicial Officer (Specify office.) Legislator (Specify House or Senate.) A. Do other immediate family members reside in your household? ☒ Yes ☐ No On this form, ”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. 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 military, or court order for emancipation. Full names of Adults and Emancipated Minors Relationship Employer Job Title Nature of Business Zachary Riley Wineburg Spouse Google Account Executive Sales The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 10 B. List only the initials of all unemancipated minors in your household below. A minor is a child under 18 years old. List the full name of each minor child on the Confidential Form at the end. Initials of Unemancipated Minors Relationship Employer Job Title Nature of Business BW Child Property Interests 1. As of December 31, 2020, did you or any 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 (Self plus Spouse) 100.00% Raleigh Wake (Self plus Spouse) 100.00% Raleigh Wake 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 2. At any time during 2019 or 2020, did you or any members of your immediate family sell to or buy from the State of North Carolina personal property worth $10,000 or more? ☐ Yes ☒ No Name of Purchaser Name of Seller Type of Property The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 Financial Interests 3. As of December 31, 2020, did you or any members of your immediate family own any of the following financial interests valued at $10,000 or more? List each company individually. A. Stock in a publicly owned company? ☒ Yes ☐ No ►Do not list interests in a widely held investment fund (including mutual funds, regulated investment companies, or pension or deferred compensation plans) if: 1. the fund is publicly traded or its assets are widely diversified; and 2. neither you nor an immediate family member are able to control the underlying assets. Owner of Interest Full Name of Company or ticker symbol Zachary Riley Wineburg (Spouse) Google 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? These include 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 Zachary Riley Wineburg (Spouse) Ally Strategies C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), 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 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, briefly describe 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, 2020, were you or any members of your immediate family the beneficiaries of a vested trust with a value of $10,000 or more that you created, established, or controlled? Do not list assets held in blind trusts. See 2021 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” https://ethics.nc.gov ☐ Yes ☒ No Name and Address of Trustee Description of the Trust Your Relationship to the Trust The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 5. As of December 31, 2020, did you any 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 Type of Creditor (commercial Bank, credit union, individual, etc.) Alissa Weiner (Self) Car Loan (Self plus Spouse) Commercial Bank Zachary Riley Wineburg (Spouse) student loan 6. List each source of income (not specific amounts) of more than $5,000 received by you or any members of your immediate family during 2020. Include salary, wages, state/local government retirement income, professional fees, honoraria, interest, dividends, rental income, business income, and other types required to be reported on State and federal tax returns. Please remember to disclose your receipt of salary or wages from any governmental or private entity. 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 Alissa Weiner (Self) State salary State Government Salary (Self plus Spouse) Property renters Rental Rental income Zachary Riley Wineburg (Spouse) Ally Strategies Consulting Salary The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Professional and Civic Relationships 7(a). During 2020, 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, literary, public health and safety, or educational purposes? ☐ Yes ☒ No - If “No,” proceed to question 8. ► Do not list State boards or entities. ► Do not list organizations of which you are a mere member. Name of Person Position Name of Nonprofit Corporation or Organization Nature 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, briefly describe the nature of that business, if known or with due diligence could reasonably be known. Name of Nonprofit Corporation or Organization Describe State Business None or Not Known 8. During 2020, were you or any 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 judicial officer or you are filing as an appointee to one of those offices. ►Do not list organizations of which you are only a member and do not serve in a leadership role. Name of Person Name of Society, Organization, or Advocacy Group Leadership Position (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 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, officer, partner, proprietor, or member or manager as of December 31, 2020. Name of Person Relationship to Filer Name of Company Role of Person Zachary Riley Wineburg Spouse Ally Strategies Proprietor 9(b). If you know that any 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, 2020, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State None or Not Known 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 2020. ☐ 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 2020, 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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 12. Are you or your employer, or any members of your immediate family, or their employers currently:  licensed by the State board or agency with which you are or will be associated or  regulated by the State board or agency with which you are or will be associated or  in a business relationship with the State board or agency 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 or you are filing as an appointee to one of those offices. Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal 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 2020, 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,  when both you and those person(s) were outside North Carolina,  under circumstances that would lead a reasonable person to conclude the gifts were given for lobbying? To answer Yes, all three conditions must apply ☐ Yes ☒ No ► Do not report gifts given by members of your extended family. ► Do not report gifts you have previously reported 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 10 15. During 2020, after you were appointed, employed, or filed or were nominated as a candidate, did you  accept a “scholarship” exceeding $200 related to your public position from a person or group of persons acting together,  when those person(s) were outside North Carolina? To answer Yes, both conditions must apply A “scholarship” is a grant-in-aid, either direct or indirect, to attend a conference, meeting, or similar event, including tuition, travel, lodging, meals, and other similar expenses. ☐ 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 you have previously reported 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, participant, or affiliate. Date of Scholarship Name and Address of Donor(s) Describe Event Estimated Market Value 16. Have you been appointed or considered for 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 made in 2020 with a cumulative total of more than $1,000 to the Council of State member who appointed you. Do not include contributions from immediate family members. ► 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.” Date Amount Contributed to The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 17. Are you an appointee or prospective appointee as: 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  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 position by a Council of State member? ☐ Yes ☒ No If “No,” proceed to question 18. e. If so, you must indicate whether during 2020 you 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: i. Collected contributions from multiple contributors, took possession of such multiple contributions, and transferred or delivered those collected contributions to the candidate or committee? ☐ Yes ☐ No ii. Hosted a fundraiser at your residence or place of business? ☐ Yes ☐ No iii. Volunteered for campaign-related activities, including 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; or (ii) an order of expungement? ☐ Yes ☒ No Offense Date of Conviction County of Conviction State of Conviction 19. Are you aware of any other information that you believe may assist the Ethics Commission in advising you concerning your compliance with the State Government Ethics Act? ☐ Yes ☒ No If yes, please provide that information below. The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 10 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 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 except for the Confidential Form regarding Unemancipated Children are public records. I have read and understand the following statutes: N.C.G.S. § 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 . . . shall be guilty of a Class 1 misdemeanor and subject to disciplinary action under G.S. 138A-45. N.C.G.S. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . 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 affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 04/15/2021 Signature Date Alissa Weiner Printed Name

For Stat Use only Dae Receives Gr STATE ETHICS COMMISSION RECEIVED ag 2020 STATEMENT OF ECONOMIC INTEREST APR15 200 NC ETHICS COMMISSION This entire form must be completed to fulfill ~-Cratiedfr msivion your ethics filing obligation. —Scanned __Date IncomoiereQs __ __ __ Supp. sent dtc br Supp. recone cate Entered n catabase or Fier’s Name (First, Middle, Last) E Prefix | First Name Middle Name [Last Name. Suffix | &k\issa Werner B Current Employer z Sob Tite 3 G ov ~ Communicvhons Dive cov Nature or Type of Business i Pobic Alaivs Reason for Filing (Complete al that apply.) State Government Job (Speciy agency and positon.) | Board/Commission (Lit the complete names of all State ’ y boards on which you are serving or are being considered.) Ow oh Goverior- Lava unions Ditthor B Judicial Officer (Spselfy office) Legisiator (Spell House or Senate) % | A. Do other immediate family members reside in your household? | Kv Ome extended family (your and your spouse's chidren, arandelldren, parents, granGparents, and 515ings, and the Spouses of cach of those persons) who reside in your household. Lst the full name of all adults and emancipated minors in your household. Minors are chidren under 16. They are | | emancipated by mariage, enlistment in the US miltary, or cour. order for emancipation aside dail SEE Full names of Adults and | Relationship | Employer Job Title Nature of Business. Emancipated Minors india 2egnang Rey, Sek (ovguttnt ey | Wins A The SET and any attachments, excluding the Confidential Form, are public records. Page 10f 10 * B. List only the initials of all unemancipated minors in your household below. A minor is 2 ld under 18 years old List the full name of each minor child on the Confidential Form at the end. | Initials of Relationship Employer [Jon Tive Nature of Business. Unemancipated A SR Property Interests 1. As of December 31, 2019, dd you or any members of your immediate family: A. have an ownership interest in North Careline eal esate (including your residence) with a market value of $10,000 or more? yes Ono Owner of Real Estate| 9% Ownership Interest | Location by City Location by County 1S | 1007 Mel Woke, 5. lease or ront rea esate or personal property o or from the State of Narth Carolina with 3 market value of $10,000 or more? Ove Hino Name of Lessor | Name of Lessee | If Real Estate, Location | If Personal property, | (Renter) by City & County Describe. 2. ACUany time curing 2018 or 2015, did you or any members of your immediate family sei to or buy from the State of North Carolina personal property worth $10,000 or more? Ove Ro [ve Fe EET PEL Name of Purchaser | Name of Seller Type of Property The SEI and any attachments, excluding the Confidential Form, are public records. Page 20110 “| Financial Interests | 3. As of December 31, 2019, did you or any members of your immediate family own any of the following financial interests valued at $10,000 or more? List each company individually. A. Stock in a publicly owned company? Yes [No > ct It terest no wily hed nvestment fund (neting motu funds, reqs vest companies, or pension or deferred compensation plans) If: 1. th fund is publicly rade or s assets ar widely dhersied; and neither you no a immediate family member are bl to corte he dering asses. Owner of Tnterest Full Name of Company or ticker symbol ark, Yowslord | Cooder | ee e————————— 5. Stock options In a company a business? Pres Ono Owner of stock Option Full Name of Company (90 not use ticker ymbor) —Ladhgws Widows | Geode C. Interests in 2 non-publicly owned company or business entity? These Include interests In sale proprietorships, Barnersips, mies Darnershs, Jo venture, Ima 13bity Companies, Imked Ibi parinernipe, and Goel hla corporations Yes [No - If "No," proceed to question 4. Owner of interest — of Company or Business Entity | 3 3 3 CC. For cach company or busines ently dented n question 5.C. (the Frmary Company), please I he Tames of any fer companies o DUKES ante in whic he PAmary Company awn Seduntie o equty ares valued ox over $10,000, f known. Non-Publicly Owned Company or Business Entity | Other Companies n which the primary Company | (the Primary Company) Owns Security or Equity Interests The SEE and any attachments, excluding the Confidential Form, are public records. Page 3 or 10 | C2). 1f you know that any entity listed in 3.C or 3.C(1) above has any material business dealings or business contract wit th State of Nari Carolina, o is related by the Sate, bref describe that business actor. Name of Company or Business Entity Description of Business Activity with the State None o Not Known A of December 31, 2019, wer you o any members of your Immediate family he beneficiaries of a vested rust win 3 Value of £10,000 0 or Sha you create, excashd o controlen? Do not list assets held in blind trusts. See 2020 SEI Helpful Tips for the definition of "Vested Trust” and "Blind Trust.” ves ne Name and Address of Tres Description tthe Trust| Vour Rtationahig a the Frost i ls ——— 5. As of December 31, 2019, did you any members of your Immediate family have lables of $10,000 or more, excluding | the mortgage on your primary Personal resence? Examples Include Cred card Gebts, aut loans, Student loans, persona oars and ita famiy Geb. Yves Ono | Name of Debtor Type of Creditor (commercial Bank, credit union, individu, ete) AN | melon 200 ML ou blown 5. st each salrce of icome-(mot specilc amounts) of more than $5,000 received by you or any members of your immeciate family dung 2015. Incude sary, wages, tte oca goverment recremant Income, prtessonal (6c, honoraria, meres, GiGends, fetal come, GUESS Come, and ner Ypes redured to oe reported on state and | federal to returns. Please remember to disclose your receipt of salary of wages from any governmental or private entity. | Do mo incude income received from the allowing sources: > Cantar gains ». Fotero government retament » Military retirement » Social security income/SSDI | Recipient of Income Name of Source Typeot Type of Income. Bininass/ Industry C11 had no reportable income over $5,000 in 2015 glare | yy honk The SEX and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 ——— —————— Professional and Civic Relationships | 7(a). During 2019, were you or any members of your immediate family a director, officer, governing board member, Rial Fy duidacb slic Ron EE pou Toye | Yes No - If "No," proceed to question 8. | [ow of Sole ie we T° oer ttt brs r ris » Do not list organizations of which you are a mere member. 4 Name Person Poston | __ Name ar oman Narre or ee ea Fos ao hes Ste ame of Nanprt Corporation ar Organization | bese ite susinss aa | | Oves (No [] Legislator/Judicial Officer - You are not required to complete this question if you are filing because 0 ot rant. ach ou rs ry a ember an ot eve dr rl Name af parson Name of Saas gman, re — o ete ous Ones reat beat amor) . ['8(a). List the name of each business with which you were associated where you or a member of your immediate tor] wan an employee, rector, officer, barter proper, of Member or manager as of becamoes 3, 2010 NameofPerson | Relationship ta Filer | __ Name of Company Role of Person | [No Business Associations (5). If you know that any entity listed in 9a) above had any material business dealings or business contracts with the Ste of North Cardin or es reguIted by he S1ate 2 of December 31, 2015, biel dence hat actly: Name of Company or Business Entity Description of Business Activity with the State 10. Are you a practicing atomey? 2 ves Re udical OfcerfState Attomey If "Yes", check each category of legal representation in which you or the law firm with which you are affiliated has earned egal ets of more them $10,000 Gur 3015. Dadministratve CJ Admiralty DO Corporate DO Criminal BN [Decedent's Estates Oisnvironmental Cinsurance Cotabor toca Government eat property secures Oe Ort gation (neusing [Utes Reguiation [Other categery nt ted redig) [11 During 2015, were you a licensed professional (other than an attorney) or did you provide consulting Services | Individually o as a member Oa professional assoubon for which you chores of wee Part over $10,0007 Oves X No I. - Nature of Services Rendered The SEX and any attachments, excluding the Confidential Form, are public records. Page sor 10 12. Are you or your employer, or any members of your immediate family, or their employers currently: + licensed by the State board or agency with which you are o wil be associated or + regulated by the State board or agency with which you are or wil be associated or +n busines relationship with the State board or agency with which you ar or wil be associated? ves re Legistator3udicial Officer - You are not required to complete this question If you are filing because Vou are a legsator or a Judicial officer or you are lng as an appointee to one of those offices Name of person Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) ——e ————— 13. Rave you or a member of your immediate family been registered a5 3 19bby at or obbyist principal within the 12 months preceding your ing of hi form? Ove to Name of Lobbyist Lobbyist’ Principal Date of Registration Registration Expiration | Other Disclosures 14. During 2015, afer you wer appointed, employed, or fied or were nominated s a candidate, did you + receive any "Gift(s)" exceeding $200 per quarter from a person or group of persons acting together, + when both you and those person(s) were outside North Carolina, + under creumstances that would ac 3 reasonable person to conclude the gifts were given for obbying? | To answer Yes, all three conditions must apply. Ores Wo sonata itu yma ot yor sid el, | » Do not report gifts you have previously reported on the “Expense Report for Exempted Persons.” | Date Item Received | Name and Address of Donor(s) Estimated Market Ee Vatue. The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2019, after you were appointed, employed, or filed or were nominated as a candidate, did you + accept a "scholarship" exceeding $200 related to your public position from a person or group of persons acting together, + when those person(s) were outside North Carolina? To answer Yes, both conditions must apply. A scholarship” is a grant-in-aid, either direct or Indirect, to attend a conference, meeting, or similar event, | including tuition, travel, lodging, meals, and other similar expenses. OYes XiNo [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 you have previously reported on the “Expense Report for Exempted Persons.” » Legislators are not required to report scholarships paid by a nonpartisan legislative organization of which the legisiator or the General Assembly is a member, participant, or affliate. Date of Name and Address of Donor(s) Describe Event Estimated Market Scholarship Value | | 16. Have you been appointed or considered for appointment to a covered board by the Governor or another Counc 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 Oves ose © If"Yes," list all contributions you made in 2019 with a cumulative total of more than $1,000 to the Council of | State member who appointed you. Do not include contributions from immediate family members. |» contributions are defined broadly in N.C.G.S. 163-278.6(6) and include “any advance, conveyance, deposi, e distribution, transfer of funds, loan, payment, gif, pledge or subscription of money or anything of value whatsoever. Date Amount Contributed to 0 No contributions) with a cumulative total of more than $1,000 The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 17. Are you an appointee or prospective appointee as: a. the head of a principal state department (5.., cabinet secretary) appointed by the Governer; or 5. a North Carolina Supreme Court Justice, Cour: of Appeals, Superior o District Court Judge; or ©. a member of any of the following boards: ves Jno + BC Commission 16 "No," proceed to question 15. + 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 + Unites Commission + vile Resources Commission 4. 130, were you appointed or are you being considered for appointment to that | Ives [I No postion by a Council of State member RAT) 1 20, you must indicate whether during 2019 you engaged in any of the following actuties with respect to or on benalf of the candcate or campaign Commitee of the Council of Sate member who appointed you: i. Collected contributions from multiple contributors, tok possesion of such multiple. contributions, and transferred or celiered those collected | (Yes [JNo Contributions to the candidate o committee” i Hosted 2 funcraise at your residence or place of business? Oves Oo i. Volunteered for campaign-related activites, including phone banks, event assistance, malings, canvassing, surveying, or any otner actly hat | Ives CINa advances the campaign of a candidate? 15. Have you over bean convicted of a felony for which you have not received eter: () 3 pardon; or (i) an order of expungement? Oves Mo offense Date of Conviction | County of Conviction | _ State of Conviction 15. Are you aware of any other Information that you believe may assist the Ethics Commission in advising you Concerning your compiance with the State Government Es Ac? ves JNo If yes, lease provide that formation below. | The SEX and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 Affirmation The information provided inthis Statement of Economic interes: and any tach ments are true, complete, and accurate {0 the best of my knowedge and belt, 1 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. | understand that my Statement of Economic Interest and any attachments except fo the Confidential Form regarding Unemancrated Coteran re pobiE focords. have read ang understand th following statutes: NCGS. § 138-26, Concealing or falling to cisciose material information | A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed ona steament of economic rest shell bt Quit of 8 Class 1 misdemaancr and suger 1 scary 2iton under G.5. 1588-45, NCGS. § 1385-27. Penaty for fase information. A fling person wno pravies false information on a statement of economic interest... Knowing tha the Information 5 fie 5 uly of 8 Clas flomy and Snll be Sublet 10 GcInry acon under 6.5. 1364-45. affirm under penalty of perjury that the foregoing is true and correct. ” EE | Kussa Ween Printed Name Submit signed, riginal documents only. Do not fax or mail this form. The SEX and any attachments, excluding the Confidential Form, are public records. Page 10.01 10

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 STATE ETHICS COMMISSION 2019 STATEMENT OF ECONOMIC INTEREST This entire form must be completed to fulfill your ethics filing obligation. ____ Checked for completion ____Scanned ______Date Incomplete Qs ____ ____ ____ ____ Supp. sent date _______ by _____ Supp. received date _________ Entered in database ______ by ______ Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Alissa Weiner Current Employer Job Title Office of the Governor Communications Director Nature or Type of Business Public Affairs Reason For Filing (Complete all that apply.) State Government Job (Specify agency and position.) Board/Commission (List complete names of all State boards on which you are serving or are being considered.) Governor, Office of the - Communications Director Judicial Officer (Specify office.) Legislator (Specify House or Senate.) A. Do other immediate family members reside in your household? ☒ Yes ☐ No On this form, ”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. 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 military, or court order for emancipation. Full names of Adults and Emancipated Minors Relationship Employer Job Title Nature of Business Zachary Riley Wineburg Spouse Google Account Executive Sales For Staff Use Only Date Received: The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 10 B. List only the initials of all unemancipated minors in your household below. A minor is a child under 18 years old. List the full name of each minor child on the Confidential Form at the end. Initials of Unemancipated Minors Relationship Employer Job Title Nature of Business BW Child Property Interests 1. As of December 31, 2018, did you or any 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 (Self plus Spouse) 100.00% Raleigh Wake 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 2. At any time during 2017 or 2018, did you or any members of your immediate family sell to or buy from the State of North Carolina personal property worth $10,000 or more? ☐ Yes ☒ No Name of Purchaser Name of Seller Type of Property The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 Financial Interests 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 or more? List each company individually. A. Stock in a publicly owned company? ☒ Yes ☐ No ►Do not list interests in a widely held investment fund (including mutual funds, regulated investment companies, or pension or deferred compensation plans) if: 1. the fund is publicly traded or its assets are widely diversified; and 2. neither you nor an immediate family member are able to control the underlying assets. Owner of Interest Full Name of Company or ticker symbol Zachary Riley Wineburg (Spouse) Google B. Stock options in a company or business? ☒ Yes ☐ No Owner of Stock Option Full Name of Company (Do not use a ticker symbol) Zachary Riley Wineburg (Spouse) Google C. Interests in a non-publicly owned company or business entity? These include 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 C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), 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 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, briefly describe 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, 2018, were you or any members of your immediate family the beneficiaries of a vested trust with a value of $10,000 or more that you created, established, or controlled? Do not list assets held in blind trusts. See 2019 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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 5. As of December 31, 2018, did you any 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 Type of Creditor (commercial Bank, credit union, individual, etc.) Alissa Weiner (Self) Auto loan Zachary Riley Wineburg (Spouse) Student loan 6. List each source of income (not specific amounts) of more than $5,000 received by you or any members of your immediate family during 2018. Include salary, wages, state/local government retirement income, professional fees, honoraria, interest, dividends, rental income, business income, and other types required to be reported on 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 Alissa Weiner (Self) State salary State Government Salary Zachary Riley Wineburg (Spouse) Google Technology Salary The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Professional and Civic Relationships 7(a). During 2018, 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, literary, public health and safety, or educational purposes? ☐ Yes ☒ No - If “No,” proceed to question 8. ► Do not list State boards or entities. ► Do not list organizations of which you are a mere member. Name of Person Position Name of Nonprofit Corporation or Organization Nature 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, briefly describe the nature of that business, if known or with due diligence could reasonably be known. Name of Nonprofit Corporation or Organization Describe State Business None or Not Known 8. During 2018, were you or any 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 judicial officer or you are filing as an appointee to one of those offices. ►Do not list organizations of which you are only a member and do not serve in a leadership role. Name of Person Name of Society, Organization, or Advocacy Group Leadership Position (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 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, officer, partner, proprietor, or member or manager as of December 31, 2018. Name of Person Relationship to Filer Name of Company Role of Person Zachary Riley Wineburg Spouse Google Employee 9(b). If you know that any 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, 2018, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State Google None or Not Known 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 2018. ☐ 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 2018, 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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 12. Are you or your employer, or any members of your immediate family, or their employers currently:  licensed by the State board or agency with which you are or will be associated or  regulated by the State board or agency with which you are or will be associated or  in a business relationship with the State board or agency 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 or you are filing as an appointee to one of those offices. Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal 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 2018, after you were (1) appointed, (2) employed, or (3) 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,  when both you and those person(s) were outside North Carolina,  under circumstances that would lead a reasonable person to conclude the gifts were given for lobbying? ☐ Yes ☒ No ► Do not report gifts given by members of your extended family. ► Do not report gifts you have previously reported 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 10 15. During 2018, after you were (1) appointed, (2) employed, or (3) filed or were nominated as a candidate, did you  accept a “scholarship” exceeding $200 related to your public position from a person or group of persons acting together,  when those person(s) were outside North Carolina? A “scholarship” is a grant-in-aid, either direct or indirect, to attend a conference, meeting, or similar event, including tuition, travel, lodging, meals, and other similar expenses. ☐ 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 you have previously reported 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, participant, or affiliate. Date of Scholarship Name and Address of Donor(s) Describe Event Estimated Market Value 16. Have you been appointed or considered for 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 made in 2018 with a cumulative total of more than $1,000 to the Council of State member who appointed you. Do not include contributions from immediate family members. ► Contributions are defined broadly in N.C.G.S. § 163A-1411(13) and include “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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 17. Are you an appointee or prospective appointee as: 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 position by a Council of State member? ☐ Yes ☒ No If “No,” proceed to question 18. e. If so, you must indicate whether during 2018 you 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: i. Collected contributions from multiple contributors, took possession of such multiple contributions, and transferred or delivered those collected contributions to the candidate or committee? ☐ Yes ☐ No ii. Hosted a fundraiser at your residence or place of business? ☐ Yes ☐ No iii. Volunteered for campaign-related activities, including 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; or (ii) an order of expungement? ☐ Yes ☒ No Offense Date of Conviction County of Conviction State of Conviction 19. Are you aware of any other information that you believe may assist the Ethics Commission in advising you concerning your compliance with the State Government Ethics Act? ☐ Yes ☒ No If yes, please provide that information below. The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 10 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 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 except for the Confidential Form regarding Unemancipated Children are public records. I have read and understand the following statutes: N.C.G.S. § 163A-191. 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 . . . shall be guilty of a Class 1 misdemeanor and subject to disciplinary action under G.S. 163A-415. N.C.G.S. § 163A-192. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415. I 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. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 04/02/2019 Signature Date Alissa Weiner Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

©," NORTH CAROLINA STATE BOARD OF | ror compuiance unr use one {RW}: ELECTIONS AND ETHICS ENFORCEMENT Date Resivss: 7 2016 STATEMENT OF ECONOMIC INTEREST |STATE BOARD OF ELECTIONS APR 162018 919-814-3600 www. ncsbe. gov/Ethics/SEI THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL conned te "YOUR SEI FILING OBLIGATION INCOR 26 me “me sro ee Sup. seeome By Supp. Received Date - FILER'S NAME (FIRST, MIDDLE, LAST) — Prefix | First Name Middle Name Last Name Suffix CURRENT EMPLOYER JoB TITLE 0. wow | (omwudicehons Divedor NATURE OR TYPE OF BUSINESS I — REASON FOR FILING (COMPLETE ALL THAT APPLY) STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (List complete name of ai State ha i | boards on which you are Serving or ar being considered Govomor's Shu ompluict | JUDICIAL OFFICER (Specify Office) i LEGISLATOR (pect House or Senate) A. Do other immediate family members reside in your household? fre (= hen used throughout this form, th tern Immediate family Includes your spouse (unless legally separated). It also inclodes members of your extended fami (your and your spouse's chien, arandchiren, parents, grandparents, and | binge, and the spouses of each of those persons) who reside In your household. st the fll name of all adults and emancipated minors in your household. A minor is & hid under 18 years old. Minors are emancpated by marriage, enstment in the US military, or court order for emancipation FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER 08 TITLE NATURE OF ‘EMANCIPATED MINORS intindl I _ ‘Business 200g Wivdong | rs A t oy Sats The SEI and any attachments, excluding the Confidential Form, are public records. Page 10f10 "|b. Ust ONLY the initials of all unemancipated minors in your household below. A minor is a child under 18 years old. Note: You must list the full name of each minor child on the Confidential Form available at the end of this document. - - — RRR INITIALS FOR | RELATIONSHIP empLOvER JOBTITLE | NATUREOF UNEMANCIPATED BUSINESS MINORS A | | | | PROPERTY INTERESTS 1. As of December 31, 2017, di you, your spouse, or members of your Immediate fom: | | a. Have an ownership interest in North Carolina reat estate (ncluing your residence) with a market value of | $10,000 or more? Hves Ono | owner of Ret Estate| o% Ownership Interest Location by County | Rusia worn Tun | oo: we | VARA |B. Lease or rent realestate or personal property to or from the State of North Carolina with a market value of | $10,000 or more? | Ove Sto Name of Lessor Name of Lessee | 1f Real Estate, Location | If Personal Property, (Renter) by City & County 1 Describe I 2. At any time during 2016 or 2017, 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? Oves Rte pT T= Name of Seer The SEI and any attachments, excluding the Confidential Form, are public records. Page 20f 10 [imanciac wrerests 3. As of December 31, 2017, did you, your spouse, or members of your immediate family own any of the following financial | Interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY, | A. stock in a publicly owned company? Yes [Ino _ _ »Do not list ownership interests in a widely held investment fund (including mutual funds, regulated investment companies, o pension or defered compentation pS) 1: (1) the. fund 1s pUbICl, Wade or vs Sobers re. wily versed; and (1) nether you no an ImmeCiats oi heheh re ab t conto Ee asets elo she mane ond, investment company, or persion o Geferred compensation pon Owner of Interest Full Name of Company (Do not use a ticker symbol) 8. Stock Options In a company or business? Rees Oto Owner of Stack Option Full Name of Company (Do not use ticker symbol) Latnaoy W Lr — |_6togie inc. Ince m2 nan-aublcy owned company or business entity (ncuding interest in soe praprotosps, partnerships, Imied partnerships, Jt ventures, imted ably companies, ited Iablty partnersgs, and | Gos hea coporatione) Doves JK{No- "No," proceed to ueston a. Owner of tnterest Name of Company or Business Entity C2). For cach non-public owned company or business enty (the ‘primary company”) dented in question | 3.C above, please ist the names of any other companies or business entities in which the primary company ons Sechriies o cauly interests vaised ot over $10,000, known: Non-publicly Owned Company or Business Entity | _ Other Companies In which the primary Company (the Primary Company) ‘Owns Security or Equity Interests Cone or hot Known The SET and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 C2). you know that any company or busiess erty sed 1 3.C or 3.C(1) above has any material business Gebings or Dsiness conkraces ith the Sua of North Caroling, ar 5 equited by the State, provid 8 oir Gescription of tar busines acti: Name of Company or Business Entity Description of Business Activity with the State A of December 31. 2017, were you, your spouse, or members of your ipmedite family the beneficiaries of 3 vested rust with 3 valu of $18,000 or more tht was created, SSabISPeG, Or cortrolod 3 your Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of "Vested Trust” and "Blind Trust.” Oves ite Name and Address of Trustee Description of the Trust Vour Relationship to the Trust S.A of December 31. 2017, di you, your spouse, o mare of your inmedite fay have ails of $10,000 or ‘more, excluding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student Toans, persona oars and ra fami debt. Noes Ovo Name of Dabtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) Indiidu, ete) Lina, wives Wor fuss Wotan _ Omnia pa 6. List each source of Income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your Immedits fomily during 2017. Tnchde salary, waes, State/ocal Government rerement, professional fees Ronorara, terest, andnds, ental income, business nome, and Cher pes of come required tbe reported on your Stat and dere to revo: Do nat include income received from the following sources: » Capital gains » Federal government retirement > Miltary retirement > Social security Income/SSD1 Recipient of Income Type of Type of Income Business/ Industry 31 ha0 no reportable Income over $5,000 in 2017. : A EE The SEX and any attachments, excluding the Confidential Form, are public records. Page 40f 10 PROFESSIONAL AND CIVIC RELATIONSHIPS 7(a). During 2017, were you, your spouse or members of your immediate family a director, officer, governing board member, employee, Independent contractor, o registered boys of 3 TORBION Comoraton of rganizavon operating 1 the State of North Carolia primary for rellous, charkable, enti, teary, PUSLE health ang safety, or cducations | | purposes? | | ves gpg rome process to auestins. * Do not Tat State boards or enles, o ents created by a polbeal subdivision of Fe State, | 3 Do not st organizations of which you are a mere member. Name of Person Wis Mer Position Nome of Nonprofit Nature of Business or +! Corporation or Organization | Purpose of Organization ] 706). Ifthe nonpro corporations or organizations sted above do business wih the Sate of North Carolina or receive Stat funds, lease provide a bi descripon of the nature of tha usIness, if Known or with which Gue diligence cout reasonably be known Name of Nonprofit Corporation or Organization Describe State Business or State Funding (J None or Not Known 8. During 2017, were you, your spouse, or members of your immediate family a director, officer, or governing board member of any ciety, organization, of 0vOChcy Grau wih 1 MLEreS i Matiars ver Which your 39ency or board say Rave Jarsdictions Ces Ave 0 Legisiator/udicial Officer - You are not required to complete this question if you are fing because Jou are legislator or 5 fudial officer or You re fing as an appointee to hose oe. D0 no ls organizations of which you are only » member (not serving in a leadership role). Name of Person Name of Society, Organization Leadership position FH or Advocacy Group (Director, officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2017. LANA Wa, WSmnA Ooa\¢ ne. Suplontl ET PT a—— 1f "Yes", check each category of legal representation in which you or the law firm with which you are affiliated has earned [J Administrative [0] Admiralty [J Corporate [] Criminal [ Decedent's Estates [J Environmental [Insurance [J Labor [0 Local Government [Real Property [Securities OTax [0 Tort litigation (including (0 utilities Regulation (0) Other category not listed. 11. During 2017.were you a licensed professional (other than an attorney) or did you provide consulting services Clves Hino TEE TTI 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 wil be associated or + Regulated by the State board or employing entity with which you are or wil be associated or + Have a business relationship with the State board or employing entity with which you are or will be associated? | Des JiNo (Jegiitonpudical Office - You ae not required to complete this gueston you ae ling because | you are 2 legislator or a judicial officer (‘judicial officer” is defined In the SEI Helpful Tips) or you are fing a5 an appalntee to those offices. | Name of Person Nome of Employer | Type of Relationship i applicable) (Licensing, Regulatory, Business) 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 ling of this form? | Oves Kno | oe, Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration — NN SR aa — | orHER DIscLosures _ _ 14. During any calendar quarter In 2017 (but only the time period after you were appointed, employed or filed or were nominated 2s 3 candidate), did you + receive any “gif(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 ime you accepted the gifi(s), and « the gif(s) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying? Oves Wino +50 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 xtem Received | Name and Address of Donor(s) | Describe Item Received = The SET and any attachments, excluding the Confidential Form, are public records. Page7 of 10 15. During 2017 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) fri sept scholars” exci $200 rom ern r grup of persons acting tether and » those person(s) were outside North Carolina and ie scharip was reed your publ pion? A schlarhi” is 8 grant-n-aid, thr direct or nicct Sind Sonaroncs, main, af Bir event, cain Son, wove, GAIN, mes AR Sher Sitar expenses ves fe 0 dil Ofer - You ar not eid to compl is question you re a dil offer you re Bin oe cm es appores. Ono report ifs ta hve prvisly been reported by you t he Degen ofthe Secretary of Sate on he Eb rhe Lear ar ot que feet cS EAB 8 ncpartan lela rgnaton of whch the gst or sami 5. mara o poate on TIE oh SORES. Sate or | Name and Adress of norte) Deserve vent scholars War you 3399PS or are you being conerd for an apparent 3 ered ear by he Gavemor or anther Counc of Std memo Council tata members ar: | > Gover r— » sector of sate > state Auton » site Tear > Suprtandent of Pubic nsticton » aomey Genera » Commision cf rire» Commiasioner of Labor + Commision of urns Oves Kno 1 "Yes, ls al contributions you (NOT Immslata tami members) made during 2017 with cumulative aor or th 31000 10h Govern sin Counc of Sete ember whe spPIISd Yu. | Contributions ae eines in 1.6.65. 163-27.66) and nis, tae ot te “ay svnce, caver, i arte of vi oa. ayn Ss Pao o Seperation st ney or aA vas whatsoever,” | ome | amem | contest Cio anton) wit cove a of mor ha $1000 The SEE and any attachments, excluding the Confidential Farm, are publi records. rages arto 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 . a member of any of the following boards: + ABC Commission + Coastal Resources Commission + State Board of Education Oves Me + State Board of Elections | « Division of Employment Security Ir “No” proceed to + Environmental Management Commission question 18. + Industral Commission + Human Resources Commission + Rules Review Commission + Board of Transportation + UNC Board of Governors. « tities Commission + Widife Resources Commission _ d. 1f 50, were you appointed or are you being considered for appointment to that | (J Yes (INo public position by a Council of State member? Council of State members are Isted | 1¢ “No,” proceed to in question 16. Question 18. . If 0, you must indicate whether during 2017 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: Oves [No I. Collected contributions from multiple contributors, took possession of such multiple Contributions, and transferred or delvere those collected | contributions to the candidate or committee? Contributions are defined in | question 16. in Hosted a fundraiser at your residence or place of business? Cves ONe ii. Volunteered for campaign-related activities, which include, but are not imited to, phone banks, event assistance, mailings, canvassing, surveying, or any | (Yes [INo other activity that advances the campaign of a candidate? 18. Have you ever been convicted of a felony for which you have not received either: (1) 2 pardon of Innocence; or (il) an order of expungement regarding that conviction? Oves ne Offense Date of Conviction | County of Conviction ‘State of Conviction 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? ves YiNo If yes, please provide such information below. The SEL and any attachments, excluding the Confidential Form, are public records. Page s of 10 AFFIRMATION ] SI PPS —S——— Confidential Form regarding Unermancipated Chlden) ac poi record. acknowledge that 1 hav rad and understand N.C.G.S. 1394-26 regarding concealing or failing o disclose teria | norman an N.C... 138427 regrin provid sc information: | § 1334-26, Concealing or Fling 0 disclose material information || Gus sement of cconamic interest under this Arte shall be guilty of a Class | misdereanoe and shall be subject to disciplinary action under G.S. 138A. | 513827. Panay for fl information || Knowing tha th information is ase i guilty of a Class H lon snd shall be subject o disciplinary acon under G5. 138A45. | Aa 41218 | Siamatire ae | Kissa Weiner | [Frm | Submit stone, ORIGINAL documents only. Do not fax or email this form, ______ The SE and any attachments, excluding the Confidential Form, are public records. Page 100110

, NORTH CAROLINA STATE ETHICS COMMISSION rok ETHICS COMMISSION USE ONLY " Pi 2017 STATEMENT OF ECONOMIC INTEREST | Out fecones 919-814-3600 www. ethicscommission.ne.gov |__| i. THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL o YOUR SEI FILING OBLIGATION | octet iti —— JE Supp. SercOme Wy __ Supp. Received Ome z ! FILER'S NAVE (FIRST, WIODLE, LAST) oo ] prefix | First Name middie tame | Last Name sume [EL — wee 1 CURRENT EnPLOYER ostme . Governor's Ow | Comwmiations Decor _ _ | FERSON FOR FILING (COMPLETE ALL THAT Appi) — STATE GOVERNMENT JOE (Speci Agency) | sonsorcommission wst compete name ota Sate | i | | Bohr on whieh yo are serving or are bing consideres) | Govemors Difue eeplogtt Soin OFFICER (sect Oe) cecroueron topey moe or Seer nD other Immediate family members reside in your household? Res No {inn ses rougnout tis form, re tem Tmmedlate family nutes vu spouse (ures al separated. Lis | chugs meres of you £xton383 ATHY (Your ON YOUT SPOS chen, grandchidren, Barents, randparents, and | Sia, and the Spouses of each of those persons) wha reside in your household: | Lat the ull ame of all adults and emancipated minors in your househald. A minor is a child under 18 years od. | Fino re cmancpoted of mariage, enn th 3 tay. or court order for emancaton. | FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER jomTe | WauReor | EMANCIPATED MINORS | — | - | ‘susiness Zoom wispy [HuSiowd | Gouge, (Raat eer | Sales i ! The SEE and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 iB. st ONLY the initials of ll unemandipated minors in your hausenold below. A minor is @ hid under 18 years ld. Note: You must list the full name of each minor child on the Confidential Form available at the | _end of this document. ul | pumaisror | RecaTioNsHIP empLOvER s08 TITLE NATURE OF UNEMANCIPATED BUSINESS Tonos —|___ _ I i. SS TE BE SE 1 - SE EE ef L - — - SVN FPS, N— oRoeRTy mreERESTS 1. As of December 33. 2016, did you, your spouse, or members of your immediate family: A. Have an ownership interest in forth Carols rel estate (incluing your residence) with 3 market vale of $10,000 o more? Oves [hve | Owner of Real Estate | % Ownership Interest | Location by City Location by County i. SE EE + SN S— SE JE _— i J | a Lense o rent eal eae or parson propery 1a rm the State of North Casing wih 8 moked vale of | £10130 or more? Oves gro Name of Lessor Name of Lessee | 1f Real Estate, Location | If Personal Property, Renter) ov City 8 County Describe | 2. A any ime during 2015 o7 2016, 91d You, Your Spouse, or members of your Immediate fomily sell © or buy from the State of North Caroline personal prooery with a market value of $10,000 or more? | Ove no | Name of purchaser Name of Seller 1 Type of Property | The SEI and any attachments, excluding the Confidential Form, are public records. Page 20f 10 | FINANCIAL INTERESTS 5. Ao of Gecemper 31,2076, 0d you, you: Ouse. of members of your immediate family wn any of th folowing friancil | teres valu i $10,000 of move? LIST EACH COMPANY INDIVIDUALLY, ! A. Stock n 2 pubicy owned company? | SB Lo omer areata 8 widely To nvasiment und (neuing mutual ans, required investment | |” Companies, or peneion or Geferred compensation plans) i: (1) the fund Is publicly traded o its assets are widely Gniarared and (1) nner vou nor sn mmeate family member are abl to onto) the asets hed n the mutual fund, esiment company or pencion or Seferred compencation pian. CO nerotimerest | Full Nam of Company (90 not uses ticker symbol) | Tadinaxy EE EC = { : - . | - smeemseeeer} 5. Stock Ogtians in a company or business? — | owner of Stock Option Full Name of Company (Do not use a ticker symbol) Lagoa Niwa, [51% \ RTA — . interests in non-publicl ovined company or business entity (including terest in sol proprietorships, earners, LTIREG BARAerEhIp, ont ventres, mec bait companies, ied 1abily garinershps, and Closely ela corporations)? Dives fie - it No,” proceed to question 4. Owner of Interest ] Name of Company or Business Entity (1), For cach non-punlicl omined company or business entay (the “primary company”) identified in question 51 ove, plaas ls the. names of any bier compan or business enties 1 which the primary company ins Sere or squity ierests aloes at over $10,000, known. N | Non-Publicly Owned Company or Business Entity Other Companies in which the Primary Company | (the primary Company) ‘Guns Security or Equity Interests | [Jone or hot Known | The SEI and any attachments, excluding the Confidential Form, are publc records. Page 30110 f € (2). If you know that any company or business entity listed in 3.C or 3.C{1) above has any material business Gesings oe business contracts th the State of North Carolina, or 15 equated by the State, provide » brie! description of that business actly. Name of Company or Business Entity Description of Business Activity with the State [ore or Not Keown 2. As of December 31. 2016, were you, your spouse, or members of your Inmate family the beneficiaries of a vested rust wih 8 vaice OF $10,000 ar ore hat wes created, establsned, or contralled by you? 26 no Ist ass held in blind trust. See 2017 SEL Helpful Tips for the definition of “Vested Trust” and "Blind Trust.” | Oves No Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 21, 2016, dit you, your spouse, or members of your mediate family have abilties of $10,000 or ore, £xCliding the morgage on your prImery personal resdence? Examples meiude cred card debts, aut loans, student aan, personal ans and iva fom dest Res One Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) Individual, otc) | Zagham wineiona | Urivvein, | 6. ist 2ach source of income (nat specific amounts) of mor than $5,000 received by you, your spouse, or members of | Jour immcste famiy during 2015. Include salary, Wades. Ste/ocal government rere, professional fees, Roncrans interest, dens, rntal ioe, business income, and Cher ype’ of Income required tbe regard on your State and fedorar tox returns. | Do nat include income received from the following sources: | » Capital gains > Federal government retirement > wilitary retirement » Social security income/SSOX Recipient of Income Name of Source Type of Type of Income. 1 | Blainess/industry 1d no reportable come aver $5,000 in 2036. oo Alissa weiner YL a ry 2d —12 | Tonos iwi | rome Vag Aesnnolas | Sue The SEI and any attachments, excluding the Confidential Form, are pubic records. Page dof 10 i — EE SR PROFESSIONAL AND CIVIC RELATIONSHIPS 718). During 2016, were you, your spouse or members of your mmesate far o director, officer, governing board ame, ony, MGependen corso, or eared by a 3 nenproft Corgan of Organon operating Sto of Morin Cok 1 mary or ros, Cnartabl, STR, IRGrary. PUD. eat an sty. or cational Purposes” Dives Kno -1f “No,” proceed to question 8. 1B rt To Ste boar ox anes, o nites created by 3 pots sbson oT he State. | » Do rot lst organizations of which you are a mere member. ~ | Name of person wiser position Name of Nompront rz | Corporation or Organization | Purpose of Organization I i | 7400. 1 the nonproti corporations o organizatons sted above do busines with th Stat of North Carolina or rece | 15k fu, iss provide 5 Did sce pn oth nan of at Doses, Known a1 wi Whi 66 digence cous | Fessonabi be know, | Name of Nonprofit Corporation or Organization | Describe State Business or State Funding 6. During 2016, were you, your spouse, or members of your immediate family a director, officer, or governing board mabe 5 any Soe. af GaN AOR, 1 A4oLACY 3100 wi TES I TEES er Wh Your 3060 of DoBKd mo ves (ve Legato duis Officer - You are not required complete his question you ae ing becouse | Tou 7e a ear x il aher of you a An a5 an SppES to hase free. 00 not Is organizations of whch you ae aly 2 member (1 serving in leadership oe). Name of Parson | Name of Society, Organization Leadership position | or Advocacy Group (Directo, Officer, Board Member) The SET and any attachments, excluding the Confidential Form, are public records. Pages orto 5a). List the name of each company or business with which you were associated where you or a member of your immediate | emer ee Name of Person | Relationship to Filer Name of Company | Roicofperson [Rhson woner | Sek ops _[Gmponet | Hiaingom codon, | Viobnd | foge ne — Cpe 3 mo to omy runes ary ted (0) shove hd vy tel Dusen dir | | business contracts with the State of North Carolina or was regulated by the State as of December 31, 2016, provide a * ie description of hat busines tnt. i Name of Company or Gusiness Entity 7 Doscription of Business Activity with the State | Cor applicable (ho entes sted on #90) | I Co TTT am — | | 10. Ace you a practicing attorney? oo Oves Jno DO udical Offcer/State Attorney | 1 "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 2016. [Administrative TS Admiralty [Corporate [Criminal || C1 pecesents estores Cenvronmental Cltnsurance Ctavor || Coca Sovernment Ce Property secures Oe | (53 7ort tigation (ncucing tities Regulation thr category not ste. | regigence) | 11. During 2016. were you a licensed professional (other than an attamey) or did you provide consulting senvices dina of a5 2 memier of a professional assocatin for Which you charged or were paid over $10,0007 Ove gine | Type of Business. | Nature of Services Rendered ] ; - —_ Saa————eriaeeeeee) —— RA R— - — The SEX and any attachments, excluding the Confidential Form, are public records. Page Gof 10 12. Ave you or your employer, your spouse or members of your immeciats family, or teir employer currently: Licensed by the Sate board o employing entay wth which you ae o il be associated oF | ese a business reltiaship ith the State board or employing entity with wich you are o wil be assodated” i [ves Hino [) Legisiator/Judicial Officer - You are not required to complete this question if you are filing because: | od res lagttor os dc! fier (Juda afc is Gained im the SEI Heltul Tips) ar you Name of person Name of Employer | Type of Relationship it applicable) | icensing, Regulatory, Business) SE Trg OEY rs Peo pvp Tm prTw—pm——r— ere yo 1e515ared 95 Such wh he 12 Tonto reced your Hing of (ys frm? i Dives Hino Name of Losbyist Lobbyists principal Date of Resisuration | Registration Expiration | . T OTHER DISCLOSURES. _ | 14. Ding any calendar quarts In 2016 (out oly the me periad ater you were appointed, employed or fled or were Riminaced 25» candids, 9 you receive any SIRs)" exceeding $200 per Guarter from 3 person or group of persons acting together, and © hen doth you and those person(s) were Qutioe North Carina at the Sime you accepted the f(s), and th Gifs) were Given under circumstances that would le 3 reasonable prsan © conclude tha they were given for lobbying? 5 not report its Gen by mea o your extended ary +05 not report gifts that have previously been reported by You to the Department of the Secretary of State on the “E.panse heport for Exempted persons” ‘Date Item Received | Name and Address of Donor(s) | Describe Item Received | Estimated Market Value The SET and any attachments, excluding the Confidential Form, are public records. Page 70f 10 15. During 2016 (st ony Ce period after you were a9R0ITed, employed, or fd or were nominated as candidate) capt a schtarshi exceeding $200 from person + group of persons aca together and | » those person(s) were outside North Carolin and the scholar wes related © your pubic pion” A scholarship” is @ grant-n-aid, ether direct or indirect, | io atiend a Conference, meeting, or similar event, including tuition, travel, lodging, meais and other | Similar expenses. Ove no (7 Judicial Officer - You are not required to complete this question if you are a judicial officer or you are | » Do not repant gifts that have previously been reported by you to the Department of the Secretary of State on the. CE pense Raper or Exempted persars.” » Logitors are nt esuired fo report Scholarships pid by a nanpartisan legislative Organizatin of which the legislator oF to Caner Asser 5 5 member o parIBant of an afloe of hat organ | EE — Date of ‘Name and Address of Donor(s) Describe Event Estimated Market Scholarship L Value | i Te. Were you s3polnted o ae you bing conser fr 3 spp 5 covered board by the Gavermar o anatnr | Council of State member? | ' Council of State members are: » Governor > Lt. Govern » Secretary of state » state Autor » State Tressurr » Superintendent of Puc Instruction » Attorney General » Commissioner of Agriculture » Commissioner of Labor | » Commissicner of Insurance 1 Cives (8h 16 “ves, lit all contributions you (NOT immediate family members) made during 2016 With a cumulative Lotar of more than $1,000.10 he Governor o other Council of State member who appointed you. | » Contrinutions are define in 4.C.G.5. 163-278.6(6) and Include, but are not mite to, “any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” | pate Amount Contributed to 1 [No contribution(s) with a cumulative total of more than $1,000 - —t _- _— == — — The SEL and any attachments, excluding the Confidential Form, are public records. Page sof 10 [£7 Ave you an appoes or rospecine appoise ta Ta the hen of 3 principal state department (9. cabinet secrexay) apoointed by the | | Comoro ! 5. Nort Carolina Supreme Cours Justice, Court of Aapeals, Superior or District | Court Judge; or | a memser of any of the following beards: | + ABC Commission | b Const Resources Commission ~ i + Stare Board of Education Ives No | | © State sore of ecu | « Division of Employment Security |= “No,” proceed to * Environmental Management Commision auestion 18. i © Industrial Commission | | | © Hursan Resources Commission | © Rules Review Commission | © Board of Transportation J © UNC aoa of Governors Utiies Commission i * wicife Rescurces Commission oo oo ] 4 120, were you appointed or are you being considered for partment to tat | (Ves [1No 1 public postin by » Council of State memaer? Council of State members are sted | 1¢ wo,” proceed to | avesten 6 ian | | i so, you must indicate whether during 2016 you (not Immedte family I | namie) engages n any of the following aches with respec to or n oehalf of | | ihe canadate o carmpasgn commie of the Cound of State member who | Sapointed vou to your pubic poston: | | Ces CiNe Collected contisuions from multiple contributors, Sook possession of such i ple Contributors, and transame or delwered those calected | Contioutons tthe candidate or cammatea? Contributions ore defined in | atest 16. | \ Hosted o uncraier a yaur residence or piace of business? [ves no 1 TT Veunteered for campaign related actwiies, nich include, bt are not hited | i 0, phone banks, event assistance, mailings, Canvassing, surveying, or any | CiYes [INo | She: Scvity hat advances ne camzaion o a ANGIE | 26. wove you ever been comcted of a [eony fo wich you nae not received ether: ()@ pardon of innocence; or 1) an | ori of expungament regarding he cormicn Ove Phono | offense | Date of Conviction | County of Conviction | _ State of Conviction | 29, Ave yeu aware of any other Informit that you belave may assis th State Ethics Commission in advising you | Condeiming our compliance we the State Government Eines AC | | Oves No ifyes, please provide such formation below. | The SET and any attachments, excluding the Confidential Form, are public records. Pages of 10 | AFFIRMATION | | affiem that th information provided in this Satetnens of Economic Interest and any attachments hereto are rue. complete, | | and accurate o the best of my knowledge and belict | | ack tht {have red and undersind N.C.G.S. 13826 regarding concsaling or fing 0 disclose material | A filing person whe haowingly conceals or knowingly fails to disclose information that is required to be disclosed | 10 disciplinary action unde G.5. 138A-45, [IETS E— Knowing ha he norton is Fhe sts of a Cas H felony and shall be subject to disciplinary scion under GS. 139A i Oltagree, = 01) EEN lel] Fr ie — | Alesawowse | Printed Name | | | Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. _ ~ } The SEL and any attachments, excluding the Confidential Form, are public records. Page 1001 10