Alton Wayne Holloman

This entire document is a public record. STATE ETHICS COMMISSION 2019 STATEMENT OF ECONOMIC INTEREST NO-CHANGE FORM This entire form must be completed to fulfill your ethics filing obligation. FOR STAFF USE ONLY Date Received: Checked for completion ______ Scanned _______ Date______ Entered in DB ____by______ Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Mr. alton wayne holloman I Reason for Filing (Complete all 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 are being considered.) Medical Board, NC Judicial Officer (Specify office.) Legislator (Specify House or Senate.) 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 public records. I have read and understand the following statutes: N.C.G.S. § 163A-191. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary action under G.S. 163A-415. N.C.G.S. § 163A-192. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415. I affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and belief. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 02/07/2019 Signature Date alton wayne holloman I Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

[NORTH CAROLINA STATE BOARD OF [REA LET ss ch | 4 ELECTIONS AND ETHICS ENFORCEMENT owe seceues 2018 STATEMENT OF ECONOMIC INTEREST | in v.34 Mos 26 NO CHANGE FORM Pst scone" ES ome 3 22H THIS ENTIRE FORM MUST BE COMPLETED TO |... oo FULFILL YOUR ETHICS FILING OBLIGATION |“ —t Er rrr — — - | proc | rst ame po ome | Last Name Sutin REASON FOR FILING {COMPLETE ALL TwaT APPLY) oo I STATE GOVERNMENT 106 (Spec Ageiy nd Poston] | BOARO/COMISSION (Ls ine camite nama of 3 State | — Sons on wich you ae serung ar are bing considered) | : 4, Wri Gatelin bot Board UOICIAL OFFICER (Specty Offce) eos TOR (spect House or senate) AFFIRMATION _ - rm mat the Information provided I this Statement of Economic Interest and ny SLITS herets ae true, Lompiate, an accurate 1 the bos of my knowledge and bee. 1 aso cory that 1 have het transfered, and wil not ansfer, any asset, Interest, or Oroperty for the purpose of Coneeaimg f f16m Gselosore snl rang an CauRable migrest | ungerstand that my Statement of Econom: Interest and any attachments or supplements thereto (ith the exception of Ine Confidenil Form regarding Unemancipated Chiron) are publ reco acknowledge that hove rad an understand .C.G.. 138A26 regarding concealing or falling to disclose material formation an 1.C.C.5. 138A-37 regarding proving ose formation § 1384.26. Conceaing or fang to disclose materia formation. A fing persan who knowingly conceals or Knowingly ais © Giscose information that s required 1 be disclosed | a mnemonic dar 01 ie sna se Sry oo ls mssemesnr and snl oc | ees Scotian scion onder 6.5. 130A-45. 5 138827. penary for fase information | A fing person who provides fais Information on a stem of cconGTIE terest 3% required Under th Article ot th fermion 1 ot 1s uy of 3 Cots. felony an shat be subject 0 Gscipknary acon under Soa [8 ee lo pre Printed Name This entire document is a public record.

Ls NORTH CAROLINA STATE ETHICS COMMISSION [rope meee HE ate Recess "4 2017 STATEMENT OF ECONOMIC INTEREST ~ NO CHANGE FORM FOR THIS ENTIRE FORM MUST BE COMPLETED TO [scannes sate FULFILL YOUR ETHICS FILING OBLIGATION [FiLer's nave (FIRST, MIODLE, LAST) A £7 Atfor) [Layne | Holle | Reason ror FiLnG (compLene a THAT Rory) oo | STATE GOVERNMENT JOB (Specify Agency and Position) SOEEQICOMMISSION (Ls the complete mame of ul State | | boaias on which you are serving or are being considered) 7 I Ny | AW JUDICIAL OFFICER (Specify Office) LEGISLATOR (Spey House or Senate) Er — eT | Trim 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 bel! | 1 aio erty that 1 have not transferred, and wil not transfer, any asset, intrest, or property for the purpose of concealing it from aclosure while retaining an equitable Interest 1 understand that my Statement of Economic Interest and any attachment or supplements thereto (wih the exception of the Confidential Form regarding Unemancipated Chidren) are publ record. acknowledge that 1 have read 3nd understand N.C... 138A-26 regarding concealing or failing to disclose material information and §.C.G.5. 136-27 regarding providing false nformaton: § 1394-26. Concesling or falling to disclose material information A filing person wha knowingly conceals or \nowinly falls to disclose information that i required to be disclosed on 3 statement of economic interest under this Arcle shall be guity of a Class 1 misdemeanor and shal be sublet to Giscpinary action under G.5. 136A-45 § 1384.27. Penalty for false information. A filing person who provides false information an a statement of economic interest as required under this Article Knowing that the information i false 5 Qulty of 3 Class felony and shal be subject o disciplinary action under | G5. 1388.45, | 1 hereby affirm that © have reviewed my most recently filed 2016 Statement of Economic Interest and that as of Docomber 31, 2016, my responses cantinue to be true, correct, and complete to the best of my knowledge. and holier. | Stree © Loma | Fenetd Kame Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form. This entire document is 2 public record.

Ls NORTH CAROLINA STATE ETHICS COMMISSION [rope meee HE ate Recess "4 2017 STATEMENT OF ECONOMIC INTEREST ~ NO CHANGE FORM FOR THIS ENTIRE FORM MUST BE COMPLETED TO [scannes sate FULFILL YOUR ETHICS FILING OBLIGATION [FiLer's nave (FIRST, MIODLE, LAST) A £7 Atfor) [Layne | Holle | Reason ror FiLnG (compLene a THAT Rory) oo | STATE GOVERNMENT JOB (Specify Agency and Position) SOEEQICOMMISSION (Ls the complete mame of ul State | | boaias on which you are serving or are being considered) 7 I Ny | AW JUDICIAL OFFICER (Specify Office) LEGISLATOR (Spey House or Senate) Er — eT | Trim 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 bel! | 1 aio erty that 1 have not transferred, and wil not transfer, any asset, intrest, or property for the purpose of concealing it from aclosure while retaining an equitable Interest 1 understand that my Statement of Economic Interest and any attachment or supplements thereto (wih the exception of the Confidential Form regarding Unemancipated Chidren) are publ record. acknowledge that 1 have read 3nd understand N.C... 138A-26 regarding concealing or failing to disclose material information and §.C.G.5. 136-27 regarding providing false nformaton: § 1394-26. Concesling or falling to disclose material information A filing person wha knowingly conceals or \nowinly falls to disclose information that i required to be disclosed on 3 statement of economic interest under this Arcle shall be guity of a Class 1 misdemeanor and shal be sublet to Giscpinary action under G.5. 136A-45 § 1384.27. Penalty for false information. A filing person who provides false information an a statement of economic interest as required under this Article Knowing that the information i false 5 Qulty of 3 Class felony and shal be subject o disciplinary action under | G5. 1388.45, | 1 hereby affirm that © have reviewed my most recently filed 2016 Statement of Economic Interest and that as of Docomber 31, 2016, my responses cantinue to be true, correct, and complete to the best of my knowledge. and holier. | Stree © Loma | Fenetd Kame Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form. This entire document is 2 public record.

oh. NORTH CAROLINA STATE ETHICS COMMISSION [oe oy PA 2016 STATEMENT OF ECONOMIC INTEREST HANGE FOR 7 oo NOC M I A———% of THIS ENTIRE FORM MUST BE COMPLETED TO [scanned Date, FULFILL YOUR SEI FILING OBLIGATION Hiro? LE (RT, WIE, AS) - - Prefix | FirstName | Middle Name 1 Last Name | suttix | Me Atha Wayso | Hollomen/ I REASON FOR FILING (SELECT ALL THAT APPLY} § | | CYSTATE GOVERNMENT JOB (Please specify the agency for [QBORRD/COMMISSION (Please list complete name of all I— — — considered) J a— [JUDICIAL OFFICER (Please specly the office you hold) | [] LEGISLATOR (Please specify House or Senate) | AFFIRMATION 1 rt format groin 1 Sateen of Sco. nares nd ay aE hres are ve Privo nghraloiiipmticdi aon Gncmanemetes hens we oh vcore 1 acknowledge thot have read nd understand N.C.G.5. 138A-26 regarding concealing o falling to disclose material | fog person who Knowing concen or knoingly al dices formation thats eed be iad on iy sn onan 5 3 § 1384-27. Penalty for false information. | Frage Fe era afi that 1 have reviewed my most recently fled 2015 Statement of Economic ntrest and that as responses eins so hoo copa Su comple 1 bes of Eman vis | CB Wa fit, ford |r Co ve Hs (omen come Submit SIGNED, ORIGINAL documents ony. 00 not fax o emit hi form. _ Toi anti document i a public record.

a NORTH CAROLINA STATE ETHICS COMMISSION *l'4] 2015 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM SITET — a naa ame oT kia EN RAs fon FLING (SHECT A THAT or) [C) STATE GOVERNMENT JOB (Please specify the agency for | [ZS0ARD/COMMISSION (Please list complete name of all ‘which you work or are being considered) ‘State boards on which you gre serving or are being So es wn V4 I 2 /[Y SOCAL GrFCER Fae pay you no) | [3 CTSLATOR (Pssst or a Sra) presm— ar tne foro pov 1s Sato Ecard a Se hereto wae, Sie va tect on he nt ard ie, a 5, rs, rape for 8 pose of coca mcs hs rt ons, sl es © ungrton o my Stement of Econ nr an ny athens spent hereto (th he exci of et ot Se Ee ee. ochre oo hve snd understand .C..5. 12026 rearing concanin or lingo disco mater ok rein rs we Pa ling person who inl concelc ing ls ici formation ut reed to be diced an A rms nd Sh bt iodo men of core ere PR ing eran who provi [ds formation saan of cori rs seed under side A roe to Seon err wr feito hereby ffm tha have reviewed my mst rcenty fied 048 Statement of Economic Interest and that 5 prey at at ave reed et ec bee wo motets Gree Pion) Vayrie Hollomors |= 26-1 int 3 Sub ESE, RITES rik i Tp TRB AS