Allyson M. Siegel

EE Gg STATE ETHICS COMMISSION a ul i) 2021 STATEMENT OF ECONOMIC INTEREST CL NO CHANGE FORM RECEIVED This entire form must be completed to fulfill FEB 11202 your SEI filing obligation. NG ETHICS COMMISSION | EE C— [TFiler's Name (First, Middle, Last) [prefix First Name Middle Name Last Name Suttn a Er isi T Reason for Filing (Complete all that apply) ‘State Government Job (Specify agency and position.) ‘Board/Commission (List the complete names of all State 50ards on whch you are serving or are being considered.) ork Carlin Col Unies, ono rosie Judicial Officer (Specify office.) Legislator (Specify House or Senate.) AFFIRMATION 1 have carefully reviewed my most recenty fied Statement of Economic Interest Long Form and my responses continue. 10 be trae, correc, anc complete a tne best of my knowledge and bell have not transfered, and wil not transfer, any asset, interes, or property or the purpose of concealing it rom diciosure whit retaining an equitable terest | ndersan na my o Crane orn i. pub recor. 1 have read and understand the following statutes: | NCGS. § 13826. Concealing or fang o disclose material information. A fling person who knowingly cancels ar knowingly fall o disclose information that is required to be disclosed on a statement of economic interest. shal be Gui of 8 Cass 1 misdemeanor and... subject to dscipnary “Chon under G.5. IRAE N.C.G.S. § 1383-27. Penalty fo false information | | A filing person who provides faise information on a statement of economic interest . . . knowing that the | information fase 15 Quit of a Cass felony and shal be Subject f disciplinary action under G.5. 1364-45. 1 affirm under penalty of perjury that the foregoing is true and correct. { Whe MN Au Al 1203) Signatire Bate Allyson M. Siegel | | Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a public record.

-. aL a— N Gp) STATE ETHICS COMMISSION Date Received: EIVED ZO, REC (ays 2020 STATEMENT OF ECONOMIC INTEREST \&& 4 NO CHANGE FORM MAR 19 2020 This entire form must be completed to fulfill Ion NG ETHICS COMM your SEI filing obligation. A 14 scanned JlIR._ome 3-9-2 0 Entered in 0B__by. Filer's Name (First, Middle, Last) RE A prefix First Name Middle Name Last Name | sumx Wo [Alon Seal Reason for Flng (Complete al that apply.) ] ‘State Government Job (Specify agency and position.) ‘Board/Commission (List the complete names of all State boards on which you are serving or ae being considered.) Ton Cons Co het Bd Tt [Judicial Officer (Specify office.) Legisator (Specify House or Senate) =] ER | 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. 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. | 1 understand that my No Change Form i a public record. Ihave read and understand the following statutes: NCGS. § 1384-26. Concealing or failing to disclose material information. A fling person who knowingly conceals or knowingly ai to disclose information that s required to be disclosed on a statement of economic interest . . shall be Guilty of a Class 1 misdemeanor and . . . subject to disciplinary action under G.5. 1384-45. NCGS. § 1384-27. Penalty for false information A filing person who provides false information on a statement of economic interest... knowing that the Information ts alse s guilty of a Class H felony and shal be subject to disciplinary action under G.S. 1384-45. Taffirm under penalty of perjury that the foregoing is true and correct. M = I a £ 203 ° Signatur Date. |r Submit signed, original documents only. Do not fax or e-mail this form. . This entire document is a public record.

RECEIVED NORTH CAROLINA Dore Recaea: MAR 18 2019 STATE ETHICS COMMISSION 2019 STATEMENT OF ECONOMIC INTEREST FE ols NO-CHANGE FORM ) bon 4 scanned $5 __oae 218] 17 This entire form must be completed to fulfill your _ ethics filing obligation. oO EC i E State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State eee LA te AW re Br rom gpriysmmerrni—— ae 3) ok 10, 6

EE EE — a 3% NORTH CAROLINA STATE BOARD OF FOR COMPLACENT, 455 HAY WA ELECTIONS AND ETHICS ENFORCEMENT [out secs © 2018 STATEMENT OF ECONOMIC INTEREST a opie] 86 NO CHANGE FORM PhoPeh Seamed OES pate3-21-13 THIS ENTIRE FORM MUST BE COMPLETED TO |... (100, FULFILL YOUR ETHICS FILING OBLIGATION Sa FILER'S NAVE (FIRST, MIODLE, LAST) Prefix | First Name Middle Name Lost Name Suffix ts. iyson Tegel REASON FOR FILING (COMPLETE ALL THAT APPL STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (Lit the complete name of al State boards on which you are serving or are being considered [North Carolina Central University JUDICIAL OFFICER (Spey Office) LEGISLATOR (Spey House or Senate) AFFIRMATION — 1 afm 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 beret. 12150 certify that I have ot transferred, and will not transfer, any asset, interest, or property for the purpose of concealing t from disclosure while retaining an equitable Interest understand that my Statement of Economic Interest and any attachments or supplements thereto (th the exception of the Confidential Form regarding Unemancipated Children) are public record. 1 acknowledge that | have read and understand N.C... 1384-26 regarding concealing or ailing to disclose material information and N.C.G.5. 1384-27 regarding providing false mermation § 1384-26. Concealing or falling to disclose material information. A filng person who knowingly conceals or knowingly fais to disclose information that i required to be disclosed on 2 statement of economic interest under tis Arice shall be quity of a Class 1 misdemeanor ang ora cx subject to disciplinary action under G.5. 130-45, § 1384-27. Penalty for false information. fling person who provides aise information on a statement of economic interest as required under tis Article knowing that the information 1s false Is Guy of a Class H felony and shall be subject to ciples actor voces GS. 1384-45. 2-25-18 — eee JLT A clipe 30 Date printed Name Sllygss Su eq el | Submit STGNED, ORIGINAL documents ony. 00 nat fx or e-mail tis form. ‘This entire document is a public record. NB Ak i,

. NORTH CAR oo (ORTH CAROLINA STATE ETHICS COMMISSION (ror srics comssion ie oi fs Date neces | 4 2017 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM : Cece to conten THE | THIS ENTIRE FORM MUST BE COMPLETED TO | scarmes____oote FULFILL YOUR ETHICS FILING OBLIGATION 7 v] 2 FILER'S NAME (FIRST, MIDDLE, LAST) [prefix | First Name Wide Name Last tame sams Allyson M. Siegel REASON FOR FILING (COMPLETE ALL THAT APPLY) __ ‘STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (Lt the complete name of al State or bears on which yor aro Serving o are being considered North Carolina Central University JUDICIAL OFFICER (Specify Office) LEGISLATOR (Specy House or Senate) AFFIRMATION ST ffm that he information provided in this Statement of Economic Interest and any attachments hereto are true, Complete, and accurate to the best of my knowledge and bel. YL also certify that I have nat transferred, and wil aot transfer, any asset, interest, o property for he purpose of concealing Irom disclosure whi retaining an equitable terest 1 understand that my Statement of Economic Interest and any attachments or Supplements thereto (wih the exception of the Confidontal For regarding Unemancipated Children) are pudlc record 1 acknowledge that | have read and understand N.C.G.S. 138-26 regarding concealing or faing to disclose materia formation and N.C... 138-37 regarding proving false mformation: § 138426. Concealing or fang to disclose material information A fing person who knowingly conceals ar knowingly fas to disclose information that is required to be disclosed on > ctovamant of aconomie interest under ths Aricle Shall bo guity of 3 Class 1 mvsdemeanar and shal be sublect to Gscpiary action under G.5. 170.45. § 1308-27. Penaty for fale information. A fling persan who provides fase information on statement of conic interest a required under this Article owing that the information 1 als 1 uity of 3 Class felony and shall be subject to disciplinary action under GS Thana. I hereby affirm that 1 have reviewed my most recently filed 2016 Statement of Economic Interest and that as of December 31, 2016, my responses continue to be true, correct, and complete to the best of my knowledge ang seller. {31 Agree } TIN 23-0) Signatu S Bate Poy dead Fea —— Submit SIGNED, ORIGINAL documents only, Do not fax or e-mail this form. _____ . This entire document is a public record.

B NORTH CAROLINA STATE ETHICS COMMISSION orem mem t & 2016 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM crud coms THIS ENTIRE FORM MUST BE COMPLETED TO {syne ote FULFILL YOUR SEI FILING OBLIGATION pay eroradin 0377 by | | FILER'S NAME (FIRST, MIDDLE, LAST) _ _ oo Prefix | First Name Middle Name. Last Name Suffix | on | ZI — ome _ { sums | [We | M Segel J REASON FOR FILING (SELECT ALL THAT APPLY) _ CISTATE GOVERNHENT JOE (Please specify the agency for | C3.80ARD/COMMISSION (Pease st complete name of ol | which you work or are being considered) State boards on which you are serving or are being | or = Commas) - | | Ince Boad of Trustees - T1UDICIAL OFFICER (Please speciy the offic you hold) | 1] LEGISLATOR (Please spc House or Senate) I — - — — - — aff that the information provided in this Statement of Economic terest and any atachments hereto are rue, complete, and accurate to the best of my knowiedge and bell. also cert that I have not transferred, and will ot transfer, any ssa, interes, or property for the purpose of concealing | understand that my Statement of Economic toterest and any attachments or supplements thereto (with the exception of | the Confidential Form regarding Unemancipated Children) are public record. I} information and N.C.G.5. 138-37 regarding providing fase formate: | 5138826. Concenling or fling to disclose mater formation filing person who knowingly conceals or knowingly fails to disclose informatian that is required to be disclosed on | a stalcment of cconamic interest undor his Arla shall be ty 1 Clas 1 misdemeanor and shal bt subse 0. | ciplinary action under G.5. 1398-45 {fing person who provides als fran on a saement of scone rest reir under is Arle | Knowing that the information is false 1 Guy of » C145 H felony and shall be Subject 10 diciplinary action under GS Tons | X heceby affirm that have reviewed my most recently filed 2015 Statemant of Economic Interest and that as of ecember 31. 3015, my fspanses anlinue 1s be te, core ad complete 51h best of my knowioson | ang beliet, CR Roree J | | Signatu Bate = Miycoy Zieqy | Fried Nome — | | Submit SIGNED, ORIGINAL documents only. Do not fax or mail this form. _ i This entire document i a public record.

4 PE 2015 STATEMENT OF ECONOMIC INTEREST a NO CHANGE FORM i FILER'S NAME (FIRST, MIDDLE, LAST) [ FistNeme [middie Name LastOR 28 1 8 47 | sunx | REASON FOR FILING (SELECT ALL THAT APPLY) IC) STATE GOVERNMENT JOB (Please specify the agency for | (fBOARD/COMMISSION (Please list complete name of all Heh you work or are being consoered) ‘State boards on wich you are serving or re being Considered a NCCU = veel Custne Cedel Jus CI UDICIAL OFFICER (lease sped th office you hold) _| [1 LEGISLATOR (Please spect House or Senate) YL affim tha th information provided In tis Statement of Economic teres and any attachments hereto are ue, Comptete, and accurate to th bet of my knowiage ang beret: | Kaisa cery tha 1 ave not transferred, and will ot transfer, any asset intrest, or property for the purpose of concealing Ie rom disclosure whi retaining an equitable terest. 1 understand that my Statement of Economic nkerst and any stachments or Supplements thereto (with the exception of the Confidential For regarding Unemancipated Chidren) ae pubic reco. } acknowledge tht have read and understand N.C.G.S. 1384-26 regarding concealing or fling to disclose materia Information and N.C.0.5. 1388-27 regaring providing false mormation: § 138A-26. Concealig o fling to disclose material information. A fling person who knowingly conceals or knowingly falls t discos information that is required o be disclosed an 5 Samant of economic cress under tris AFC hall bs uly o 3 Class 1 misdemeanor and snl be Subject to Gacpinary action under 6.5. 138A.45. 5 1388.27. Penatty or false information. A fling person who provides flse Information on a statement of economic Interest a5 required under ts Arce Knowing tt he Information 14 ale 15 ult of a Clos felony and shal be subject 1 GscpIary action under Frat © hereby affirm that X have reviewed my most recently filed 2014 Statement of Economic Interest and that as of December 33, 2014, my responses continae to be tue, correct, and complete to tne best of my Knowledge “nd bet. 7 Agree Mlysod Siege) 4-2-1 Fried Rome So Submit SIGNED, ORIGINAL documents only. Da mot fax or const this form. ET

Ji, NORTH CAROLINA STATE ETHICS COMMISSION i] J; 2015 STATEMENT OF ECONOMIC INTEREST = NO CHANGE FORM FILER NAME (FIRST, MIDDLE, LAST) 05 APR 13M & 50 First Name. iddia Name Lat ame [ surtn | Siegel LL] REASON FOR FILING (SELECT ALL THAT APPLY) CJ STATE GOVERNMENT JOB (Please specify the agency for | [XBOARD/COMMISSION (Please list complete name of all Wh you work or are being considered) State boards on which you are serving o a boing C1) UDICIAL OFFICER (Please specty th office you hokd) _| [LEGISLATOR (Please speciy Howse or Senate) AFFIRMATION affirm tha the information provided n this Statement of Economic Interest and any atachments hereto are rue, complet, and accurate 2 the bet of my knowiedae and bole. 1els0 cently tht hove nt tcansferred, and will no anor, any asset, eset, o property for the purpose of concealing from disclosure whe retaining an cquiabe ntorest. understand that my Statement of Econamic Interest ond any atachrments or supplements thera (with the exception of ha Confidential Form regarding Unemancipeted Chien) ar public record. acknowledge that 1 have read and understand N.C.G.5. 1384-26 regarding conceiing o failing to disclose material mation 3nd .C.G.S. 1334-27 regarding proving fie formation: 5 1384-26. Conceaing o ang to disclose material normation. A ing person who knowingly conceas o knowingly als o disclose Information tht i recuied t he disclosed on a statement of cconomic interest under thi AR Shall be Qty of a Gass 1 misdemeanor and shall be subject cipinary action onder G.5. 13645 513827. Penalty for fle formation. A fling person who provides fase Information on satement of economic terest a required under this Aric knowing that the information fle 5 Suity of a Cass H flony and nll ie subst scpinary acon under G5. Tans. I harsh affirm that I have reviewed my most recently led 2014 Statement of Economic Interest and that ss of December 31, 2014, my responses continue 1 be rus, correct, and complete to the best of my knowledge and bait, {hares Bsoy Murs Siegel 1-83-15 Figg Nome Tate Doin ‘Submit SIGNED, ORIGINAL documents anly. Bo not fax or ermal this form: Sana This entire document is a public record.