Alma Adams

7%, NORTH CAROLINA STATE ETHICS COMMISSION SAE " Ny ol Pa 2015 STATEMENT OF ECONOMIC INTEREST PA SIIES CONNIBSIN USE Gh 919-715-2071 ww ethcscommission.nc.gov 100 FR 16 PH 2:29 [15 First Name [ wiodietame [ iasthame [sux | Alma Fam [= Us Congre CJ STATE GOVERNMENT J08 (Please specify the agency for | [] BOARD/COMMISSION (Please ls complete name of al which you work or are being considered) State boards on which you are serving or are being considered CL UDICIAL OFFICER (Please speciy the ofice you hol) Tout 19H = 207% 00 other imgnediate family members reside in your household? Over too When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also includes members of your extended fomily (your and your spouses chiren, grandchildren, parents, grandparents, and Sibings, and the spouses of each of thase parsons) who reside in your household. ONLY LIST THE INITIALS OF UNEMANCIPATED CHILDREN. However, you MUST submit the childrens ull names on the ‘Confidential orm avellable t the end of this document, Minors are emancipated by marriage, enlistment in the US miltary, or cout action for emancipation. [EMANCIPATED MINORS usIness The SEI and any attachments, excluding the Confidential Form, are public records. Page 10f10 INITIALS FOR EMPLOYER RGD Catone PROPERTY INTERESTS Ff Daca 31.2016, 5 you, your se, or meres of your ids ay: ave 2 ovr rast n lot Goan ol state (cleo yout ence ith 3 ret vali of $10.00 So Wes (Ino TTT EY TT TTY 4 Lh EC hl IP Pog. | Gurenshorw | Cu lfnd 5 se or et en cao ps rot 2 1 Se a Nath Cra vn aie le of 30.00 Ove wo ame of Losar Name of asses | If Ra Estate Location | Parson Property, (Renter) by City & County Describe 2. At any time during 2013 or 2014, did you, your spouse, or members of your immediate family selLto or buy from the ‘State of North Carolina personal property with a market value of $10,000 or more? Oves 6 — —— — The SEK and any attachments, xclucing th Confidential Farm, ar public records. [I 5 of DEcambar 31, 2014, 6 you, your spaues, of memes of your Inmedata fomy own any of th fling financial eres valued at 410.000 or mare? A. Stock in 3 pully owned company? ove fe +00 at fist ownership interests in a widly held investment fund including mutual funds, regulated investment Companies, o pension or dutered ormpentation Bian) ) th fund is pubiEly aded or 5 33sec are widely vrais and i ner you no on Imma Fly Tere ar 0 COnTal he aSets ek he sl un, vectment company, of pene or eféred compensation pan. [ ownerotimersst Full Name of Company (Do not use a ticker symbol) [— } ] 1] | 5 Stock Oats na company o business? ves fhe Owner of Stock Option Full Name of Company (Do not uss ticker symbol) tacts 2 non aubIEl owned company o business ny (ncn Interests nse proprietors, a. Fed paras Jom vate med opty Compares, ited abit partners and Covey nel cprporatons? [ ownerotmmeres | Name of Company or Business Entity The SEL and any attachments, excluding the Confidential Form, are public records. Page 30110 00 For each non-publcly owned company or business entity (iv “primary company”) dentiied i question 3.C Cover ise 8 he names of ay other companies or BUSIeSS iis in whieh he primary compo owns Secures or ety teres voued ot ovr $10,600, known. Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (ine Primary Company) whe Security or Equity Interests hone or tot known 1 you know Wht any company or business ent sted n 3.C or 3.CCL) above ha any material busines a mass comcast ve Sate of North Coron o eglaed oth Seat, rove ort dscnpion of that busines act. Name of Company or Business Entity Description of Business Activity with the State | (None or Not Known I} ————— | 4. As of December 31, 2014, were you, your spouse, or members of your immediate family the beneficiaries of a vested va 5 510,600 0 here nat wes created, csablshed, o controled by you? Do not lst assets held in blind trusts. Tis for te vesteq Trust and “Bind Trust.” | ove ho Name and Address of Trustee Description of the Trust Your Relationship tothe Trust 5. As of December 31, 2014, did you, your spouse, or members of your immediate family have liabilities of $10,000 or Bo ason- on your ian personal esonces Exampics Include cra Sard debts, auto loans, CiSoent aan, personal loans and nkra-famly Geb Ares Oto Name of Debt (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Viambery fnaividunt, ete) Alma Ada Commaceal Genk The SET and any attachments, excluding the Confidential Farm, are public records. Page dor 10 6. List each source of income (not specific amounts) of more tha $5,000 received by you, your spouse, or members of your immediate family during 2014. Include salary, wages, state/local government retirement, professional fees, or eevee andonds. sera Income, business income, and cher types of Income required to be reported on your Sve and federal tox returns. Do tot include income received from the following sources: » Capital gains > Federal government retirement > Military retirement » Social security income/SSDX Recipient of Income Name of Source Type of Type of Income. Blainass Industry (11 ad no reportable income over $5,000 n 2014 Hens Ada fate Ret fui lb, Leashes | is leans | cis Aca {1 |oalet as Gren ent | oom car | | temt-bomed PROFESSIONAL AND CIVIC RELATIONSHIPS 7(0) Outing 2014, were you, your spouse or members of your Immediate family a decor, officer, governing board miber amployse, independent contractor, or registered 1obbyst of 3 nonprofit Corporation o organization operatng in ne State of Noth Corona primary fo religious, chantable, scientific, erary, pubic health and safety, o educational purmoses? (Ses [No - If No", proceed to question 8. Do not lst State Boards or antics, or enties created by a polical subdvison of he sam. + Da not lst organizations of which you ae a mere member. oo Name of Person Hie Hor Position Name of Nonprofit Nature of Business or Corporation of Organization | Purpose of Organization 2) K / 705). If the nonproft corporations or organizations [sted above do business with the State of arth Corolla or receive Slate unde, pleose provide a brie description of the nature of tha business, i known or with which due dilgence could easonably be known Name of Nonprofit Corporation or Organization Describe State Business or State Funding None or Not Known 7] ’ Jie. ter oo Ai can fm cae fifebe Atsran] The SEX and any attachments, excluding the Confidential Form, are public records. Pages of 10 Lh ves fe Cl toghlter ion! Offa «ou re no equi 0 complet his question you a ing cause immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2014. | contracts with the State of North Carolina or was regulated by the State as of December 31, 2014, provide 3 brief TTR hr 10. Are you a practicing attorney? OS —— legal fees of more than $10,000 during 2014. CJ Administrative [) Admiralty 0 Corporate [3 Criminal I During 2014, were you o licensed professional (other than an attorney) or did You provide consulting services ndidually or 25 » member of 3 professional association for which you charged of were paid over $10,0007 Oves One Type of Business Nature of Services Rendered eer————— 12. Are you or your employer, your spouse or members of your immediate family, o their employer currently: + Licensed by the State board or employing entity with which you are of wil be associated or + Requisted by the State board or employing entity with which you are or willbe associated or . a A) the State board or employing entity with which you are or will be associated? [ves (fo [Legislator udical Officer - You are not required to complete this Question if you are fing becouse You'are a egilator o a Judicial officer (ul officer” defined n the SEL Helpful Tis) or you are Ting 3s an appointee to those offices. Name of Person Name of Employer Type of Relationship i applicable) (Licensing, Regulatory, Business) 13. Are you, your spouse or a member of your immadiatg family currently registered as 3 lobbyist or lobbyist principal, or were you registered as such within the 12 months preceding your fing of hs form? Oes oe Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration OTHER DISCLOSURES 14. During any calendar quarter in 2014 (but only the time period after you were appointed, employed or filed or were nominated as a candidate), dd you + receive any “gif(s)” exceeding $200 per quarter from a person or group of persons acting together, and + when both you 3nd those person(s) were outside North Carolina at the time you accepted the gif(s), and + the git(s) were given under circumstances that would lead a reasonable person to conclude that they were given for Tonbying? Oves ¥ho 5 not report gts given By members of your extended family. 200 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 tem Received _| Estimated Market Value The SEI and any attachments, excluding the Confidential Form, are public records. Page 7ar 10 f During 2014 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) accept a “scholarship exceeding $200 fom a parson or group of parsons acting tosecher and those persone) were outside North Carlin and the scholarship was related t your public positon? A “scholarship” is a grant-n-aid to aitend a conference, acing of iar evens. ing 203 dio lier appotes » Do not report its tht hve previously bean resorted by You to the Department o the Secretary of tat on the Spares Raper or Exempted arsons.” > Logsltos re not required o teprt scholarships pid by nonpartisan aisle orgascation of which th egisotor or hs Goneral Psa 5 8 maron o paecpart of oh hats of ho rgememion. Dutear | Name and Address of bonor(s) Eetimated Market Schatarenip Vase 16. Ware you apponted or re you bg comdered for an appaTmeTt 1 3 covered board by the Governor o snot Como Soe amber Council of State members are: > Governor + tt. Governor > Socatary of sate » State Aur » state Trssurer > Superintendent of Pubic Insructon » Atorey General » Commissioner of Agriculture.» Commissioner of Lobo » Commissioner of Insurance Oves dfvo Yes, lst all contributions you (NOY Imma family members) made during 2014 with a cumulative total of more than $3,000 5 the Governor or other Counch of tats member whe appaited rou. > Contributions are defined in 1..G:. 163-278.6(6) and include, bu ae nt mia, “any adhance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” bate [amen] Contributed to Who comriutionts) with cumiativ ear of more ha $1,000 The SEE and any attachments, excluding the Confidential Form, are public records. Pager 10 Te you a sols o prospec SPOR PRT —p pe —p——T ins b. a Hoth Corona Supreme Court Justice, Cour of Appeals, Superior or District Court : Sete rorn A ac Commision ~ State Bosra of Education Oves a © Se Soweto rr © Somat Empiogen Sec I Nor, proceed to © Enronmanta Momapemen: Commission estion 18. © inert Commision aman Resources Commission tes Review Commision Bom a Teavaporaton ONC toad o Covers iis Comission * Witte Aesmyees Commission d. 1f so, were you appointed or are you being considered for appointment to that public |] Yes []No EN re Ebi iy va A Avision 16. question 18. PO TTI II rp ————— tim ft owing ace wih ras ron pov oft AAR A Wt Ad tie bs A Toso pa aman | Colectad contributions from mule contributors, ook possesion of such os A RA tp ry i Hosted fundraser at your residence or piace of usiess” [Ove ome | Ti Vlunteres fo campaigned oct, whieh includ, at a nt rad t, i [cyves. Ime rs apes to Spore of Snot 5. Taye you svar bean convicted fa ony for whch you hve mat received ater: (1 pardon of nnacence a (an arama ego ey coms DYes Who --ii Date of Conviction | _ County of Conviction | _ State of Conviction _| To veo mar of amy hr ran at 720 Beers ay ee Te Ste is Comte 4a You oe anes wih te Se Coven Eves The SEE and any attachments, excluding the Confidential Form, are public records. Pages of 10 AFFIRMATION aft ht the information provided inthis Statement of Banani terest and any aachments eet ee re, complet, and aera th best of my Knowledge and ber. ls ceriy ha 1 hav no ransfred, and ill no ant, any ase, terest, propery fo the papas of concealing it Ha ma Tunderstand that my Statement of Economic Interest and any attachments or supplements thereto (vith the exception of the ‘Confidential Form regarding Unemancipated Children) are public record. acknowledge hat nave read nd understand N.C. 5 138A.26 regain concealing or fun o disclose materi infomation and N.C.G5 138A.37 regarding providing fle norman § 138A-26. Concealing or failing to disclose material information. A fling person who knowingly concen o knowingly ful 0 disclose information te is eqied to be dclossd on tent of somite andes hs Al shall b Bly af Class 1 misdemeanor an shall uc 16 Schima scion under GS. 139AS. §138A.27. Penalty or fle formation A ing puss wh proves fe information on ant of soni eta seq under tis Ale knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under GS. Fonds Otagree Atma Adams Printed Name y/ RY ZE _ 4-As rT Date Submit SIGNED, ORIGINAL documents only. Do not fx or cull his form. The SEE and any attachments, excluding the Confidential Form, are public records. Page 100110