Allen K. Buansi
2026 CandidateHouse of RepresentativesLocal Governmental Employees' Retirement System
Filings
2026 2026 Candidate
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2026 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
Mr. Allen Buansi
Current Employer Job Title
NC General Assembly Representative
Nature or Type of Business
Representing District 56 in the General Assembly.
Reason For Filing (Complete all that apply.)
Are you a 2026 CANDIDATE for an
elected office requiring an SEI filing?
☒ Yes ☐ No If yes, for what office are you a candidate? (Specify name of
office seeking in box below.)
Do you currently hold this office? ☒ Yes ☐ No NC House
State Government Job or Post-Service Filer (Specify
agency and position.)
Board/Commission (List complete names of all State boards
on which you are serving or are being considered for
appointment.)
Judicial Officer, Post-Service Filer, or Judicial Officer
Appointee (Specify office.)
Legislator, Post-Service Filer, or Appointee to Legislative
Office (Specify House or Senate.)
House of Representatives
A. Do any immediate family members currently reside in your household?
☒ Yes ☐ No
”Immediate family” includes your spouse (unless legally separated) and unemancipated children (minors under 18 years
of age). 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 residing 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
Sarah Kowitt Spouse UNC-CH Assistant Professor Researches on several
initatives.
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
IB Child
MB Child
ZB Child
Property Interests
1. As of December 31, 2025, 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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 2024 or 2025, did you or any members of your immediate family sell or buy personal property
TO or FROM the State of North Carolina with a market value of $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, 2025, did you or any members of your immediate family own any of the following financial
interests valued at $10,000 or more?
A. Stock in a publicly owned company?
☒ Yes ☐ No
► List the name of each company in which you own holdings of $10,000 or more. Do not list the number of shares or
value of your holdings.
► List all stocks held individually of in a portfolio managed by a financial services company. Listing a financial services
company which manages your stock portfolio is insufficient, you must list the names or all individual stock holdings
with a market value of $10,000 or more.
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
Sarah Kowitt (Spouse) Apple, Inc.
B. Stock options in a company or business?
☐ Yes ☒ No
Owner of Stock Option Full Name of Company
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
The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10
4. As of December 31, 2025, 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 by you?
Do not list assets held in blind trusts. See SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
https://ethics.nc.gov/seis
☐ Yes ☒ No
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
5. As of December 31, 2025, did you any members of your immediate family have liabilities of $10,000 or more, excluding
the mortgage on your primary personal residence? If yes, specify the type of debt. Examples include credit card debts,
auto loans, student loans, personal loans and intra-family debt. Do not disclose the amount of the debt or the name
of creditor.
☒ Yes ☐ No
Name of Debtor Type of Creditor (commercial bank, credit union,
individual, etc.)
Allen Buansi (Self) U.S. Department of Education
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 2025. 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. You must disclose your receipt of salary or wages from any governmental or private
entity, including those already listed in response to other SEI questions.
Do not include income received from the following sources:
► Capital gains ► Federal government retirement
► Military retirement ► Social security retirement, survivors, or disability benefits
Recipient of Income Name of Person or Entity
from Which Income Was
Received
Type of
Business/Industry
Type of Income
Allen Buansi (Self) NC General Assembly Government Salary
Sarah Kowitt (Spouse) UNC-CH University Salary
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
Professional and Civic Relationships
7(a). During 2025, 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, or entities created by local governments.
► 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. As of December 31, 2025, were you or a member of your immediate family an employee, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 for profit business with which you or a member of your immediate family was an employee,
director, officer, partner, proprietor, or member or manager as of December 31, 2025.
Name of Person Relationship to Filer Name of Company Leadership Position
No Business Associations
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, 2025, 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/In House/Employee 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 2025.
☐ 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 2025, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 Date
Other Disclosures
14. During 2025, 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 “Reportable Expenditures Made by Persons Exempted” form.
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 2025, 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 filing solely because you
are a legislator or judicial officer or as a candidate or appointee to those offices.
► Do not report gifts you have previously reported on the “Reportable Expenditures Made by Persons Exempted” form.
► 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. Were you appointed or considered for appointment to a covered board by the current Governor or another currently
serving 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 2025 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 yes, were you appointed or are you being considered for appointment to that
position by a currently serving Council of State member?
☐ Yes ☒ No
If “No,” proceed to
question 18.
e. If yes, you must indicate whether during 2025 you engaged in any of the following
activities with respect to or on behalf of the candidate or campaign committee of a
currently serving 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 01/20/2026
Signature Date
Allen Buansi
Printed Name
2026 House of Representatives
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2026 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
Mr. Allen Buansi
Current Employer Job Title
NC General Assembly Representative
Nature or Type of Business
Representing District 56 in the General Assembly.
Reason For Filing (Complete all that apply.)
Are you a 2026 CANDIDATE for an
elected office requiring an SEI filing?
☒ Yes ☐ No If yes, for what office are you a candidate? (Specify name of
office seeking in box below.)
Do you currently hold this office? ☒ Yes ☐ No NC House
State Government Job or Post-Service Filer (Specify
agency and position.)
Board/Commission (List complete names of all State boards
on which you are serving or are being considered for
appointment.)
Judicial Officer, Post-Service Filer, or Judicial Officer
Appointee (Specify office.)
Legislator, Post-Service Filer, or Appointee to Legislative
Office (Specify House or Senate.)
House of Representatives
A. Do any immediate family members currently reside in your household?
☒ Yes ☐ No
”Immediate family” includes your spouse (unless legally separated) and unemancipated children (minors under 18 years
of age). 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 residing 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
Sarah Kowitt Spouse UNC-CH Assistant Professor Researches on several
initatives.
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
IB Child
MB Child
ZB Child
Property Interests
1. As of December 31, 2025, 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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 2024 or 2025, did you or any members of your immediate family sell or buy personal property
TO or FROM the State of North Carolina with a market value of $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, 2025, did you or any members of your immediate family own any of the following financial
interests valued at $10,000 or more?
A. Stock in a publicly owned company?
☒ Yes ☐ No
► List the name of each company in which you own holdings of $10,000 or more. Do not list the number of shares or
value of your holdings.
► List all stocks held individually of in a portfolio managed by a financial services company. Listing a financial services
company which manages your stock portfolio is insufficient, you must list the names or all individual stock holdings
with a market value of $10,000 or more.
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
Sarah Kowitt (Spouse) Apple, Inc.
B. Stock options in a company or business?
☐ Yes ☒ No
Owner of Stock Option Full Name of Company
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
The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10
4. As of December 31, 2025, 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 by you?
Do not list assets held in blind trusts. See SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
https://ethics.nc.gov/seis
☐ Yes ☒ No
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
5. As of December 31, 2025, did you any members of your immediate family have liabilities of $10,000 or more, excluding
the mortgage on your primary personal residence? If yes, specify the type of debt. Examples include credit card debts,
auto loans, student loans, personal loans and intra-family debt. Do not disclose the amount of the debt or the name
of creditor.
☒ Yes ☐ No
Name of Debtor Type of Creditor (commercial bank, credit union,
individual, etc.)
Allen Buansi (Self) U.S. Department of Education
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 2025. 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. You must disclose your receipt of salary or wages from any governmental or private
entity, including those already listed in response to other SEI questions.
Do not include income received from the following sources:
► Capital gains ► Federal government retirement
► Military retirement ► Social security retirement, survivors, or disability benefits
Recipient of Income Name of Person or Entity
from Which Income Was
Received
Type of
Business/Industry
Type of Income
Allen Buansi (Self) NC General Assembly Government Salary
Sarah Kowitt (Spouse) UNC-CH University Salary
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
Professional and Civic Relationships
7(a). During 2025, 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, or entities created by local governments.
► 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. As of December 31, 2025, were you or a member of your immediate family an employee, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 for profit business with which you or a member of your immediate family was an employee,
director, officer, partner, proprietor, or member or manager as of December 31, 2025.
Name of Person Relationship to Filer Name of Company Leadership Position
No Business Associations
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, 2025, 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/In House/Employee 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 2025.
☐ 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 2025, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 Date
Other Disclosures
14. During 2025, 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 “Reportable Expenditures Made by Persons Exempted” form.
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 2025, 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 filing solely because you
are a legislator or judicial officer or as a candidate or appointee to those offices.
► Do not report gifts you have previously reported on the “Reportable Expenditures Made by Persons Exempted” form.
► 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. Were you appointed or considered for appointment to a covered board by the current Governor or another currently
serving 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 2025 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 yes, were you appointed or are you being considered for appointment to that
position by a currently serving Council of State member?
☐ Yes ☒ No
If “No,” proceed to
question 18.
e. If yes, you must indicate whether during 2025 you engaged in any of the following
activities with respect to or on behalf of the candidate or campaign committee of a
currently serving 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 01/20/2026
Signature Date
Allen Buansi
Printed Name
2025 House of Representatives
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2025 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM
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
Mr. Allen Buansi
Reason for Filing (Complete all that apply.)
Are you a CANDIDATE for elected office? ☐ Yes ☒ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this position? ☐ Yes ☐ No
State Government Job or Post-Service Filer (Specify
agency and position.)
Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Judicial Officer, Post-Service Filer, or Appointee (Specify
office)
Legislator, Post-Service Filer, or Appointee (House or
Senate)
House of Representatives
This entire document is a public record.
AFFIRMATION
I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue
to be true, correct, and complete to the best of my knowledge and 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 No Change Form is a public record.
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 04/15/2025
Signature Date
Allen Buansi
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2024 House of Representatives
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2024 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM
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
Mr. Allen Buansi
Reason for Filing (Complete all that apply.)
Are you a CANDIDATE for elected office? ☒ Yes ☐ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this position? ☒ Yes ☐ No NC House
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Judicial Officer or Filing Post-Service (Specify office.) Legislator or Filing Post-Service (Specify House or Senate.)
House of Representatives
AFFIRMATION
I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue
to be true, correct, and complete to the best of my knowledge and 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 No Change Form is a public record.
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 01/22/2024
Signature Date
Allen Buansi
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2023 House of Representatives
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2023 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
Mr. Allen Buansi
Current Employer Job Title
Poyner Spruill Of Counsel
Nature or Type of Business
Advising and counseling some local government clients and contract review.
Reason For Filing (Complete all that apply.)
Are you a CANDIDATE for
elected office?
☐ Yes ☒ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this
position?
☐ Yes ☐ No
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.)
Judicial Officer or Filing Post-Service (Specify office.) Legislator or Filing Post-Service(Specify House or Senate.)
House of Representatives
A. Do any immediate family members reside in your household?
☒ Yes ☐ No
On this form, ”immediate family” includes your spouse (unless legally separated) and unemancipated children (minors
under 18 years of age). 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
Sarah Kowitt Spouse UNC-CH Assistant Professor Researches on several
initatives.
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
IB Child
MB Child
ZB Child
Property Interests
1. As of December 31, 2022, 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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 2021 or 2022, did you or any members of your immediate family sell or buy personal property
worth $10,000 or more to or from the State of North Carolina?
☐ 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, 2022, 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
Sarah Kowitt (Spouse) Apple, Inc.
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
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, 2022, 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 2023 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
https://ethics.nc.gov/seis
☐ 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, 2022, 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. Do not disclose the amount of the debt.
☒ Yes ☐ No
Name of Debtor Type of Creditor (commercial Bank, credit union,
individual, etc.)
Allen Buansi (Self) U.S. Department of Education
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 2022. 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. You must disclose your receipt of salary or wages from any governmental or private
entity, including those already listed in response to other SEI questions.
Do not include income received from the following sources:
► Capital gains ► Federal government retirement
► Military retirement ► Social security retirement, suvivors, or disability benefits
Recipient of Income Name of Source Type of
Business/Industry
Type of Income
Allen Buansi (Self) City of Greensboro Municipality Salary
Sarah Kowitt (Spouse) UNC-CH University Salary
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
Professional and Civic Relationships
7(a). During 2022, 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, or entities created by local governments.
► 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
Allen Buansi (Self) Board Member Kidzu Children's Museum Provide a interactive,
learning environment for
children
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
Kidzu Children's Museum None 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 have
jurisdiction?
☐ Yes ☐ No ☒ Legislator/Judicial Officer -You are not required to complete this question if you are filing solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 for profit business with which you or a member of your immediate family was an employee,
director, officer, partner, proprietor, or member or manager as of December 31, 2022.
Name of Person Relationship to Filer Name of Company Role of Person
No Business Associations
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, 2022, 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/In House/Employee 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 2022.
☐ 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 2022, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 2022, 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 2022, 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 filing solely because you
are a legislator or judicial officer or as a candidate or appointee to those offices.
► 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 2022 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 2022 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 04/17/2023
Signature Date
Allen Buansi
Printed Name
2022 House of Representatives
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2022 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
Mr. Allen Buansi
Current Employer Job Title
City of Greensboro Assistant City Attorney
Nature or Type of Business
Advising and counseling two city departments. Contract review.
Reason For Filing (Complete all that apply.)
Are you a CANDIDATE for
elected office?
☒ Yes ☐ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this
position?
☒ Yes ☐ No NC House
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.)
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
House of Representatives
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
Sarah Kowitt Spouse UNC-CH Assistant Professor Researches on several
initatives.
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
IB Child
MB Child
ZB Child
Property Interests
1. As of December 31, 2021, 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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 2020 or 2021, 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, 2021, 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
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
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, 2021, 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 2022 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, 2021, 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.)
Allen Buansi (Self) U.S. Department of Education
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 2021. 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
I had no reportable income
over $5000 in 2021.
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
Professional and Civic Relationships
7(a). During 2021, were you or any members of your immediate family a director, officer, governing board member,
employee, independent contractor, or registered lobbyist of a nonprofit corporation or organization operating in North
Carolina primarily for religious, charitable, scientific, 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
Allen Buansi (Self) Board Member Common Cause North Carolina Voting advocacy
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
Common Cause North Carolina None or Not Known
8. During 2021, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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, 2021.
Name of Person Relationship to Filer Name of Company Role of Person
No Business Associations
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, 2021, 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 2021.
☐ 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 2021, 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 solely
because you are a legislator or judicial officer or as a candidate or appointee to 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 2021, 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 2021, 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 filing solely because you
are a legislator or judicial officer or as a candidate or appointee to those offices.
► 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 2021 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 2021 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 06/07/2022
Signature Date
Allen Buansi
Printed Name
2021 Local Governmental Employees' Retirement System
Document text
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
Mr. Allen Buansi
Current Employer Job Title
UNC-Chapel Hill Deputy Director
Nature or Type of Business
Research center.
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.)
Local Governmental Employees' Retirement System
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
Sarah Dorothy Kowitt Spouse UNC-Chapel Hill Postdoctoral Fellow Research
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
IB Child
MB Child
ZB 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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
Sarah Dorothy Kowitt (Spouse) Apple
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
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.)
Allen Buansi (Self) Student Loan Servicer
Allen Buansi (Self) Credit Union
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
Allen Buansi (Self) UNC-Chapel Hill Public University Salary
Allen Buansi (Self) Town of Chapel Hill Municipality Salary
Sarah Dorothy Kowitt
(Spouse)
UNC-Chapel Hill Public University 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
Allen Buansi (Self) Board Member Common Cause North Carolina Voting Rights Advocacy
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
Common Cause North Carolina 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.
Local Governmental Employees' Retirement System
Name of Person Name of Society, Organization,
or Advocacy Group
Leadership Position
(Director, Officer, Board Member)
Allen Buansi (Self) Town of Chapel Hill Council 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
Allen Buansi Self UNC-Chapel Hill Employee
Allen Buansi Self Town of Chapel Hill Board Member
Sarah Dorothy Kowitt Spouse UNC-Chapel Hill 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, 2020, briefly describe that activity.
Name of Company or Business Entity Description of Business Activity with the State
Town of Chapel Hill None or Not Known
UNC-Chapel Hill None or Not Known
UNC-Chapel Hill 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
Note: I have not earned any legal fees during 2020.
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.
Local Governmental Employees' Retirement System
Name of Person Name of Employer
(if applicable)
Type of Relationship
(Licensing, Regulatory, Business)
Allen Buansi (Self) Town of Chapel Hill Regulatory
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
No Contributions
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 04/01/2021
Signature Date
Allen Buansi
Printed Name
2020 Local Governmental Employees' Retirement System
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2020 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
Mr. Allen Buansi
Current Employer Job Title
UNC-Chapel Hill Attorney-Fellow
Nature or Type of Business
Research center.
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.)
Local Governmental Employees' Retirement System
Local Governmental Employees' Retirement System
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
Sarah Dorothy Kowitt Spouse UNC-Chapel Hill Postdoctoral Fellow Research
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
ZB Child
Property Interests
1. As of December 31, 2019, 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
Allen Buansi (Self) 100.00% Chapel Hill Orange
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 2018 or 2019, 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, 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
►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
Sarah Dorothy Kowitt (Spouse) Apple
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
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, 2019, 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 2020 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, 2019, 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.)
Allen Buansi (Self) Student Loan Servicer
Allen Buansi (Self) Credit Union
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 2019. 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
Allen Buansi (Self) UNC-Chapel Hill Public University Salary
Allen Buansi (Self) Town of Chapel Hill Municipality Salary
Sarah Dorothy Kowitt
(Spouse)
UNC-Chapel Hill Public University Salary
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 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,
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
Allen Buansi (Self) Board Member Common Cause North Carolina Voting Rights Advocacy
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
Common Cause North Carolina None or Not Known
8. During 2019, 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.
Local Governmental Employees' Retirement System
Name of Person Name of Society, Organization,
or Advocacy Group
Leadership Position
(Director, Officer, Board Member)
Allen Buansi (Self) Town of Chapel Hill Council 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, 2019.
Name of Person Relationship to Filer Name of Company Role of Person
Allen Buansi Self UNC-Chapel Hill Employee
Allen Buansi Self Town of Chapel Hill Board Member
Sarah Dorothy Kowitt Spouse UNC-Chapel Hill 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, 2019, briefly describe that activity.
Name of Company or Business Entity Description of Business Activity with the State
Town of Chapel Hill None or Not Known
UNC-Chapel Hill None or Not Known
UNC-Chapel Hill 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 2019.
☐ 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
Note: I have not earned any legal fees during 2019.
11. During 2019, 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.
Local Governmental Employees' Retirement System
Name of Person Name of Employer
(if applicable)
Type of Relationship
(Licensing, Regulatory, Business)
Allen Buansi (Self) Town of Chapel Hill Regulatory
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 2019, 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 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.
☐ 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 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, deposit,
distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value
whatsoever.”
Date Amount Contributed to
No Contributions
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 2019 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 05/10/2020
Signature Date
Allen Buansi
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2019 Local Governmental Employees' Retirement System
Document text
. or sat use ony
# we
NORTH CAROLINA | “FFECEIVED
Zl Sire Toad of Ficcoms Fils Enforcement
APR 152018
> IISSION
2019 STATEMENT OF ECONOMIC INTEREST ¥ SER FPL
This entire form must be completed to fulfill Incomplete Qs Lb. 16 lok
your ethics filing obligation. Supp. sentdate by _
i —
Eneed in duabase ov
Fler's Name (First, Middle, Last) RE
prefix | First Name [Middle Name Last Name suttix_|
Aller Buns: a
Curren Employer Job Tie
Univouky & North Crohns Cut §r (at Rl] Pfbroey - Flow
Nature or Type of Business |
Reseda Cotes 1
Reason For Filing (Complete al hat apply)
| State Government Job (Specify agency and position.) Board/Commission (List complete names of all State boards
or whch you are serving o ae being Conmeredy |
Loc Goumat Enpors Boteornb Syren
Sort & Toon
Suda Oicer (Spec office) Legisator (Spacty House or Senate) T
A. Do other immediate family members reside in your household?
Gres Ono |
On this form, “immediate amy” includes your spouse (less gol separate). It ao cues members of your |
extended fry (your and your spouse’ Children, arandeiaren, parents, rand, and slings, and th Spouses |
of cach of 1056 persons) who reside in your household.
| List the ful name of al adults and emancipated minors in your household. Minors are children under 16. They ore |
| Smancpares by marmade, snistment tne 05 miRaTes or our oro or ersomepasn. gate)
Full names of Adults and [weve Nature of Business
emancipated Miners re
[Sac Kot [fncg [Og A [Boot Foes evra
The SEX and any attachments, excluding the Confidential Form, are public records. Page 1010
6. Uist only the initials of all unemancipated minors in your household below. A minor s a hid under 16 year cid. |
List the full name of each minor child on the Confidential Form at the end. i |
Ea ——
Unemancipated |
I EE |
Property Interests |
1. As of December 31, 2018, dd you or any members of your mmedate fami:
A. have an ovinership interest in North Carolina real estate (including your residence) with a market value of
$10,000 or more?
Ove gro |
|__Owner of Real Estate | %% Ownership Interest | Location by Cty Location by County |
— SE
8. lease or rent realestate or personal property to or from the State of North Carolina with a market value of |
$10,000 or more? |
OYes @No |
Name of Lessor Name of Lessee | If Real Estate, Location | If Personal Property,
| (Renter) by City & County Describe |
[ I
2. Atany time during 2017 or 2015, did you or any members of your immediate family sell t or buy from th State of
North Caring personal property worth $10,000 or more?
Oves 20
Tr EO TP YT)
|
—
= —
|
SE —
[1
The SEX and any attachments, excluding the Confidential Form, are public records. Page 20f 10
Financial Interests
3. As f December 31, 2018, dd you or any members of your Immediate fami own any of th following financil
are waves 10,000 or are Lik ach compar indioteaty: |
A. Stock in a publicly owned company?
[ves Oto
Do at ot terest na widely eld vest fund (including mukal funds, reuated Ivesmert compares, or
rion of deere compensation pa |
Lt ur pooh Satad or Ke ecse are willy ders and.
2 nother you nor a mediate fom member art apt t Crit the undertying assets
Owner of Interest Full Name of Company or tcker sym!
Secon Kowith Apple (APPLY
Disacy (DLS 1
I
[rp p———— |
Oves @No
owner of stack option Full Name of Company (Ba not use ticker =ymbol)
Interests i non-public owned company o busines antiy? These incude interests I so proprietors, |
Darnershios, ed panes, FE arturo, Woke la companies, ated bey Pamrerahpe ond
| re comoretiom.
| DOYes ®No- If "No," proceed to question 4. |
se Name of Company or Business Entity
EE ——— |
C0). For cach company o business ety denied n cussion .C. (he “Primary Company’), pease Is
the names of ay ofr Companies o Dusmess eniges is whch th Primary Company ows secures or
Cy ares vee ove S101000 Hm
Non-Putlicly Owned Company or Business Entity | _ Other Companies in which the primary Company |
i ne Primery Sommpanys whe Security or Edun Interacts |
J None or not known
EE
The SEI and any attachments, excluding the Confidential Form, are public records. Page 30r 10
€ (2). 1f you know that any entity ited in 3.C or 3.C(1) above has any material business dealings or business
contracts with the State of North Carona or i regulated by the State, briefly describe that business activity.
Name of Company or Business Entity Description of Business Activity with the State |
CI None or Not Known CC |
-}
|
| 4. As of December 31, 2018, were you or any members of your immediate family the beneficiaries of a vested trust with |
| Value ar £10,000 or more tht you created, established or controled? |
Do not list assets held in blind trusts. See 2019 SEI Helpful Tips for the definition of "Vested Trust” and "Blind Trust.”
Oves @No |
—
5. As of December 31, 2018, did you any members of your immediate family have liabiltes of $10,000 or more, cxclucing |
the mortgage on your primary personal residence? Examples Include red card debts, auto loans, student loans, |
personal loans and intr. family debt. |
Qe Oto |
Name of Debtor Type of Creditor (commercial Bank, credit union,
individual, etc.) -
ok Loves Stadt F—
6. List each source of income (mot specific amounts) of more than $5,000 received by you or any members of your |
immediate family during 2018. Include salary, wages, state/ocal government retirement income, professional fees,
honoraria, interest, dividends, rental income, business income, and other types required to be reported on State and
fedora! tax returns.
Do mot include income received from the following sources: |
» Capital gains » Federal government retirement |
| » Miltary retirement > Social security income/SSDI |
Recipient of Income Type of Type of Income.
Business/ Industry |
C11 had no reportable income over $5,000 n 2018 1]
Allen Buansi [UNE] Ruble Unwri¥ Salo, J
J
The SEI and any attachments, excluding the Confidential Form, are public records. Page dof 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, independant contractor, or rcistered labbyist of 2 Nonprofit corporation or organization operating in North
Carolina primary for religious, charitable, scentic trary, public health and safety, or educational purposes? |
[OYes [ZNo - If "No," proceed to question 8. |
> Do mot st State boards or entities.
> Do not ist erganizations of which you are a mere member, |
Name of person Position Name of Nonprofit Nature or |
Corporation or Organization | Purpose of Organization
7(6). If tne 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 dilgence could reasonably oe known,
Name of Nonprofit Corporation or Organization Describe State Business |
CI None or Not Known |
. . -
[8 During 7016, were you or any members of your immediate family 3 directo, officer, or Governing board meTber of |
any socety, organization, or advocacy Group with an interest in matters over which Your agency o board may nave
Jurisdiction? |
CIYes CINo [JLegislator/ludicil Officer - You are not required to complete this question f you are fling because |
You are a legislator or judicial officer or you are filing as an appointee to one of those offices. |
D0 not list organizations of which you are only a member and do not serve in a leadership rol. |
Name of Person Name of Saciety, Organization, Leadership Position
or Advocacy Group (Director, Officer, Board Member)
Alen Buansi Town oF Cred WI Toon Gaurdil | Boor) Sommer |
I —
(— S—
The SEI and any attachments, excluding the Confidential Form, are public records. Page Sof 10
9(a). List the name of each business with which you were associated where you or a member of your immediate far |
| was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2016. |
| |
Name ot person | Relationship toFier | Nameof company | Molet parson |
CINo Business Associations 1
Plier Buen unc-ch fifo Flow |
- oun oF TTY Ton ourer |
Alen Baas: Ble pron gon Get weer |
Suan Youite ech titer Rw |
9(b). If you knows that any entity sted n 9(a) above had any material business dealings or business contracts wh the
State of North Carolina or was regulated by the State as of December 31, 2015, ify describe that ac
Name of Company or Business Entity Description of Business Activity with the state |
CINGt applicable (No entities fisted on #92)
10. Are you a practicing attorney? |
| @Yes ONo Choudical Officerstate Attorey |
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 2016,
0 adminisrative admiralty 0 Corporate Ocrminal
| Opececents estates Cenvironmentsl Dlinsurance Oltabor |
| Otocal Government [CIReal Property OI Securities OTax |
negligence) |
11. During 2018, were you a licensed professional (other than an attorney) or did you provide consulting services |
indiviculy or 25 a member of a professional association for which you charged or were paid over $10,007 |
Oves no |
I Type of Business Nature of Services Rendered |
— 1
The SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10
FE pep —————
= 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 ae or will be associated or |
in business ean with th Sete Sarda gene with whch you ar o wil be sssocted?
Tivos Bo Lepsistortudica rice You arent rr compete hs question you sre lig becuse
Yodan a ego or 8 lem HE yo ar so app ere he Se
[ amectrarson Name of employer Type of meatonsi
| (if applicable) (Licensing, Regulatory, Business)
— lL
— !
[5 ave you or member of your medias amily See regard a abba obo prec wi nc 1
mon rece ou ig of i
ove mo
Name of Lobos Costs rnp ouwar | Region
14. Ouig 2018, ar you were sppontes, employed or led were rome 3 3 ont, ou
«Teche sy “GR” xceen $200 er arr rom rion ogous of person sc ogee
wn both you and thse erent) were ote North Carin,
under reumstaces tht wkd ed resonable person to Concude the gifs were given for obi?
To amar Yo, a res conitors mk so
| ow ow
[mor eet a ve oy members a your ended Fay,
Do nt pur ots you hve previ reported onthe “Expense Report fo Exempted persons.
oat Hom Recived | Name and Address of Oonor(s) | Describe lem Receved | Estimated marker
prs
The SE and any tachment, excluing the Confidential Form, ar publi rocords pase 70110
15. During 2018, after you were appointed, employed, or filed or were nominated as a candidate, did you
at a Shae Sr ee
ER Ra
|
| LC
| ‘State member?
eon
yes [no
oe omens yy m3 33318 ka mts ent rashag FLR pss
sr DL
EE — -
"17. Are you an appointee or prospective appointee as: E
a. the 1d of principal sate department (3, cabinet secretary) appointed by the
2 Nort Carolina Supreme Court Justice, Court of Appeals, Superior or District
Cou uae or
. a member of any of th following boards:
2 A8c Commission
Const Resources Commission
« State Board of Education [Yes [No
State Board of Elections and Ethic Enforcement
~ Divison of Employment Securty 2 Nos procesd to
~ Envronmental anagement Commision Gestion 18.
~ Indusrl Commission
| 2 Vman Resources Commission
| = Ras Review Commision
| Saavaof Trnaportaton
| 2 URC board of Governirs
| 2 iiies Commission
| = Wide nesaurces Commission I
d. If so, were you appointed or are you being considered for appointment to that [yes [No
Boston by Coun of Sa members a eon 84
auestion 18.
e130, you must indicate whether during 2018 you engaged any ofthe flown
ao wr ESPON of Sh Io of coo sm
Te Counc of Sore meme whe spported sou:
I. Collected contributions fom mute contributors, took possesion of such | C1 ves (IN
ile Commons and anatenes or eiverc os vented
Contributions to th canddate or comme
Hosted a fundrtsr at your residence or lace of buses? Oves One
[7 Volunteered for campign elated aces, including phone banks, overt
| ositonce, Malings, Canvass, Surveying, or any ator acti thor aovances | C1 ¥es [No
the campaign of a cantor
[5-H you ever bean convicted of a lon fo wh you hve nt eceed ahr: () pardon; ar 1) an order of
| mpaments
| ov aw
ottense Date of Conviction | _ County of Conviction | _ State of Conviction
15: you aware of ony ther formation hat you believe may assist the State Board of Elections and Eves
Enforcement I SWAG you concerning You compance win th Soe Government Ses ety
[OIYes [No If yes, please provide that information below.
I
f——————————————————————
The SEI and any attachments, excluding the Confidential Form, are public records. Page sof 10
| affirmation
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
tothe best of my knowledge and belle!
| have not transferred, and will nt transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest
1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding
Unemancipated Children are pubic records.
| have re an understand th owing statutes:
| N.C.G.5. § 1634-191. 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 gui of 8 Class 1 misdemeanor and subject to dscrinary
action under G.5. 1634-415.
NCGS. § 1638-192. Penalty for fase information.
| Afiing person who provides false information on a statement of economic interest . . . knowing that the
| information false is guilty of a lass H felony and shall be subject to disciplinary action under G.5. 1634-415.
Laff tha 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 bet
Taffirm under penalty of perjury that the foregoing is true and correct.
(AE RE EA G
|
| Men Bugs
| Printed flame
| Submit signed, original documents only. Do not fax or e-mail this form. I
The SEX and any attachments, excluding the Confidential Form, are public records. Page 100f 10
2018 Local Governmental Employees' Retirement System
Document text
COMPLETE THIS FORM AND MAIL SIGNED, ORIGINAL TO
STATE ETHICS COMMISSION, 1324 MAIL SERVICE CENTER, RALEIGH, NC 27699-1324
NORTH CAROLINA STATE BOARD OF ELECTIONS
AND ETHICS ENFORCEMENT
2018 STATEMENT OF ECONOMIC INTEREST
919-814-3600 www.ncsbe.gov/Ethics/SEI
FILER'S NAME (FIRST, MIDDLE, LAST)
Prefix First Name Middle Name Last Name Suffix
Mr. Allen Kwabena Buansi
CURRENT EMPLOYER JOB TITLE
UNC Center for Civil Rights Attorney-Fellow
NATURE OR TYPE OF BUSINESS
Research
REASON FOR FILING (SELECT ALL THAT APPLY)
STATE GOVERNMENT JOB (Specify Agency) BOARD/COMMISSION (List complete name of all State
boards on which you are serving or are being considered)
Local Governmental Employees' Retirement System;
JUDICIAL OFFICER (Specify Office) LEGISLATOR (Specify House or Senate)
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of
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A. Do other immediate family members reside in your household?
Yes No
When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also includes
members of your extended family (your and your spouse’s children, grandchildren, parents, grandparents, and siblings, and the
spouses of each of those persons) who reside in your household.
List the full name of all adults and emancipated minors in your household. A minor is a child under 18 years old. Minors are
emancipated by marriage, enlistment in the US military, or court order for emancipation.
FULL NAME OF
ADULTS &
EMANCIPATED
MINORS
RELATIONSHIP EMPLOYER JOB TITLE NATURE OF
BUSINESS
B. List 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.
INITIALS FOR
UNEMANCIPATED
CHILDREN
RELATIONSHIP EMPLOYER JOB TITLE NATURE OF
BUSINESS
PROPERTY INTERESTS
1. As of December 31, 2017, did you, your spouse, or members of your immediate family:
A. Have an ownership interest in North Carolina real estate (including your residence) with a market value of $10,000 or more?
Yes No
Owner of Real Estate % Ownership Interest Location by City Location by County
B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of $10,000 or more?
Yes No
Name of Lessor Name of Lessee (Renter) If Real Estate, Location by
City & County
If Personal Property, Describe
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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?
Yes No
Name of Purchaser Name of Seller Type of Property
FINANCIAL INTERESTS
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 No
Do not list ownership interests in a widely held investment fund (including mutual funds, regulated investment companies,
or pension or deferred compensation plans) if: (i) the fund is publicly traded or its assets are widely diversified; and (ii)
neither you nor an immediate family member are able to control the assets held in the mutual fund, investment company, or
pension or deferred compensation plan.
Owner of Interest Full Name of Company (Do not use a ticker symbol)
B. Stock Options in a company or business?
Yes No
Owner of Stock Option Full Name of Company (Do not use a ticker symbol)
C. Interests in a non-publicly owned company or business entity (including interests in sole proprietorships, partnerships, limited
partnerships, joint ventures, limited liability companies, limited liability partnerships, and closely held corporations)?
Yes No If "No", proceed to question 4.
Owner of Interest Name of Company or Business Entity
The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of
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C (1). For each non-publicly owned company or business entity (the “primary company”) identified in question 3.C above,
please list the names of any other companies or business entities in which the primary company owns securities or equity interests
valued at over $10,000, if known.
Non-Publicly Owned Company or Business Entity (the
Primary Company)
Other Companies in which the Primary Company Owns
Security or Equity Interests
None or Not Known
C (2). If you know that any company or business entity listed in 3.C or 3.C(1) above has any material business dealings or
business contracts with the State of North Carolina, or is regulated by the State, provide a brief description of that business activity.
Name of Company or Business Entity Description of Business Activity with the State
None or Not Known
4. As of December 31, 2017, were you, your spouse, or members of your immediate family the beneficiaries of a vested trust with a
value of $10,000 or more that was created, established, or controlled by you?
Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
Yes No
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
5. As of December 31, 2017, did you, your spouse, or members of your immediate family have liabilities of $10,000 or more,
excluding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student loans, personal
loans and intra-family debt.
Yes No
Name of Debtor (You, Spouse, Immediate Family Member) Type of Creditor (Commercial Bank, Credit Union,
Individual, etc.)
The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of
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6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your
immediate family during 2017. Include salary, wages, state/local government retirement, professional fees, honoraria, interest,
dividends, rental income, business income, and other types of income required to be reported on your State and federal tax returns.
Do not include income received from the following sources:
Capital gains Federal government retirement
Military retirement Social security income/SSDI
Recipient of Income Name of Source Type of Business/Industry Type of Income
I had no reportable income over $5,000 in 2017.
Allen Buansi UNC Chapel Hill University Salary
Allen Buansi State of North Carolina Department of Justice Wages
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, or registered lobbyist of a nonprofit corporation or organization operating in the State of North
Carolina primarily for religious, charitable, scientific, literary, public health and safety, or educational purposes?
Yes No If "No", proceed to question 8.
Do not list State boards or entities, or entities created by a political subdivision of the State.
Do not list organizations of which you are a mere member.
Name of Person His/Her Position Name of Nonprofit
Corporation or Organization
Nature of Business or Purpose
of Organization
Allen Buansi Attorney-Fellow UNC Center for Civil Rigths Research, Training for Law
Students, Legal Assistance
7(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive State funds,
please provide a brief description of the nature of that business, if known or with which due diligence could reasonably be known.
Name of Nonprofit Corporation or Organization Describe State Business or State Funding
None or Not Known
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of
11
Please answer the following question as it pertains to the following board/agency:
Local Governmental Employees' Retirement System
8. During 2017, were you, your spouse, or members of your immediate family a director, officer, or governing board member of any
society, organization, or advocacy group with an interest in matters over which your agency or board may have jurisdiction?
Yes No Legislator/Judicial Officer - You are not required to complete this question if you are filing because you are a
legislator or a judicial officer or you are filing as an appointee to those offices.
Do not list organizations of which you are only a member (not serving in a leadership role).
Name of Person Name of Society, Organization or
Advocacy Group
Leadership Position (Director, Officer,
Board Member)
Allen Buansi Chapel Hill Town Council Town Councilmember
9(a). List the name of each company or business with which you were associated where you or a member of your immediate family
was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2017.
Name of Person Relationship to Filer Name of Company Role of Person
No Business Associations
Allen Buansi Filer UNC Center for Civil Rights Attorney-Fellow
9(b). If you know that any company or business entity listed in 9(a) above had any material business dealings or business contracts
with the State of North Carolina or was regulated by the State as of December 31, 2017, provide a brief description of that business
activity.
Name of Company or Business Entity Description of Business Activity with the State
Not applicable (No entities listed on #9a) No relationship / Not known
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 2017.
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.
The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of
11
11. During 2017, were you a licensed professional (other than an attorney) or did you provide consulting services individually or as a
member of a professional association for which you charged or were paid over $10,000?
Yes No
Type of Business Nature of Services Rendered
Please answer the following question as it pertains to the following board/agency:
Local Governmental Employees' Retirement System
12. Are you or your employer, your spouse or members of your immediate family, or their employer currently:
• Licensed by the State board or employing entity with which you are or will be associated or
• Regulated by the State board or employing entity with which you are or will be associated or
• Have a business relationship with the State board or employing entity with which you are or will be associated?
Yes No Legislator/Judicial Officer - You are not required to complete this question if you are filing because you are a
legislator or a judicial officer (“judicial officer” is defined in the SEI Helpful Tips) or you are filing as an
appointee to those offices.
Name of Person Name of Employer (if applicable) Type of Relationship (Licensing,
Regulatory, Business)
13. Are you, your spouse, or a member of your immediate family currently registered as a lobbyist or lobbyist principal or were you
registered as such within the 12 months preceding your filing of this form?
Yes No
Name of Lobbyist Lobbyist’s Principal Date of Registration Registration Expiration
OTHER DISCLOSURES
The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of
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14. During any calendar quarter in 2017 (but only the time period after you were appointed, employed or filed or were nominated as a
candidate), did you
• receive any gift(s) exceeding $200 per quarter from a person or group of persons acting together, and
• when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and
• the gift(s) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying?
Yes No
Do not report gifts given by members of your extended family.
Do not report gifts that have previously been reported by you to the Department of the Secretary of State on the "Expense
Report for Exempted Persons."
Date Item Received Name and Address of
Donor(s)
Describe Item Received Estimated Market Value
Please answer the following question as it pertains to the following board/agency:
Local Governmental Employees' Retirement System
15. During 2017 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) did you
• accepted a “scholarship” exceeding $200 from a person or group of persons acting together and
• those person(s) were outside North Carolina and
• the scholarship was related to your public position? A “scholarship” is a grant-in-aid, 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 that have previously been reported by you to the Department of the Secretary of State on the “Expense
Report for Exempted Persons.”
Legislators are not required to report scholarships paid by a nonpartisan legislative organization of which the legislator or
the General Assembly is a member or participant or an affiliate of that organization.
Date of Scholarship Name and Address of
Donor(s)
Describe Event Estimated Market Value
The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of
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Please answer the following question as it pertains to the following board/agency:
Local Governmental Employees' Retirement System
16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or another Council of
State member?
Council of State members are:
• Governor • Lt. Governor • Secretary of State
• State Auditor • State Treasurer • Superintendent of Public Instruction
• Attorney General • Commissioner of Agriculture • Commissioner of Labor
• Commissioner of Insurance
Yes No
If “Yes”, list all contributions you (NOT immediate family members) made during 2017 with a cumulative total of more than
$1,000 to the Governor or other Council of State member who appointed you.
Contributions are defined in N.C.G.S. 163-278.6(6) and include, but are not limited to, “any advance, conveyance, deposit,
distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.”
Date Amount Contributed to
No contribution(s) with a cumulative total of more than $1,000
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Please answer the following question as it pertains to the following board/agency:
Local Governmental Employees' Retirement System
17. Are you an appointee or prospective appointee to:
a. the head of a principal state department (e.g. cabinet secretary) appointed by the Governor;
or
b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court Judge;
or
c. a member of any of the following boards:
• ABC Commission
• Coastal Resources Commission
• State Board of Education
• State Board of Elections
• Division of Employment Security
• Environmental Management Commission
• Industrial Commission
• Human Resources Commission
• Rules Review Commission
• Board of Transportation
• UNC Board of Governors
• Utilities Commission
• Wildlife Resources Commission
Yes No
If "No", proceed to question
18.
d. If so, were you appointed or are you being considered for appointment to that public
position by a Council of State member? Council of State members are listed in question 16.
Yes No
If "No", proceed to question
18.
e. If so, you must indicate whether during 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:
i. Collected contributions from multiple contributors, took possession of such multiple
contributions, and transferred or delivered those collected contributions to the candidate
or committee? Contributions are defined in question 16.
Yes No
ii. Hosted a fundraiser at your residence or place of business? Yes No
iii. Volunteered for campaign-related activities, which include, but are not limited to,
phone banks, event assistance, mailings, canvassing, surveying, or any other activity that
advances the campaign of a candidate?
Yes No
18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon of innocence; or (ii) an order of
expungement regarding that conviction?
Yes No
Offense Date of Conviction County of Conviction State of Conviction
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19. Are you aware of any other information that you believe may assist the State Ethics Commission in advising you concerning your
compliance with the State Government Ethics Act?
Yes No If yes, please provide such information below.
AFFIRMATION
I affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and
accurate to the best of my knowledge and belief.
I also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the
Confidential Form regarding Unemancipated Children) are public record.
I acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information
and N.C.G.S. 138A-27 regarding providing false information:
§ 138A-26. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a
statement of economic interest under this Article shall be guilty of a Class 1 misdemeanor and shall be subject to disciplinary
action under G.S. 138A-45.
§ 138A-27. Penalty for false information.
A filing person who provides false information on a statement of economic interest as required under this Article knowing that
the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45.
I Agree. It is my intention that this check box constitutes my electronic signature. By checking this box I certify that the
information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the
best of my knowledge and belief.
Filed Electronically 3/26/2018
Signature Date
Allen Kwabena Buansi
Printed Name
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