Alvin Williford Daughtridge
Caldwell Community College & Technical Institute Trustees
Filings
2025 Caldwell Community College & Technical Institute Trustees
Document text
5 FOR STAFF USE ORLY
Jean STATE ETHICS COMMISSION Bate Recenved:
lr fi] 2025 STATEMENT OF ECONOMIC INTEREST CEIVED
= No Change Form APR 07 2025
This entire form must be completed to fulfill
Your SEI filing obligation. NCETHICS Commission
[Flersar (Fist Mode, ast) 0 Be SR eR Teme 1B
SOR Sean [BS
Prefix | First Name Middle Name Last Name Suffix
Mr. | Alvin Williford Daughtridge
Reason for Filing (Complete all that apply.) :
Sie Coreen oo Fl os See Saad oper an Bow Comin (Ls he compte somes ora soe bo
Tl LE woman i ers ra
- Institute Board of Trustece
este SE JET
oon © TE See TE JT
AFFIRMATION
have carefully reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue |
to be true, correct, and complete t the bes of my knowledge and belief. |
Ihave not transferred, and wll not transfer, any asset interes, or property forthe purpose of concealing I from
disclosure whi retaining an equitable terest.
Tunderstand that my No Change Form is public record.
Ihave read and understand the folowing statutes:
N.C.G.S. § 1384-26. Concealing or eling to disclose material information.
A filing person who knowingly conceals or knowingly fais to disclose Information thats required to be disclosed
on'a Statement of economic Interest» shal be Qu of a lass 1 misdemeanor and... subject to discpinary
action under G.5. 136A-45.
N.C.G.S. § 1384-27. penalty for flse information
A filing person who provides fae information on a statement of economic terest... knowing that the
information 5 fose 5 uty of a Cass H felony and shall be subec to disciplinary action under G.5. 138A-45.
1 affirm under penalty of perjury that the foregoing is true and correct.
Wp io. Das [efi D3-2L 2024
Signatu Pe Date
Plow to: Dyeslteilee
Frinted Name
Submit signed, original documents only. Do not fax or e-mail this form.
This document Is a public record.
2024 Caldwell Community College & Technical Institute Trustees
Document text
. FOR STAFF USE ORY
ARR STATE ETHICS COMMISSION Oerhecaived:
We
(ay) 2024 STATEMENT OF ECONOMIC INTEREST
Nally 7 RECEIVED
FEZ No Change Form
WAR 11 2024
This entire form must be completed to fulfill
your SEI filing obligation.
NC ETHICS COMMISSION
Filer's Name (Fst, Middle Last)
[Prefix | ristiame [middie name | Last Name Suttx
Reason for Filing (Complete al that apply.)
State Government 105 (Specly agency and postion) | Board/Commission (Lit the complete names of all State
boards on whch you ae serving or re being considered.)
Surrently Serving as 3 Judicial OFicer (Specify office Urrently Serving 5 3 Leguaiator [Spec House or Senate.)
“Fe vou 3 CANDIDATE for 3 covered elected office? IF yes, speciy office and Act county appIcable:
(District, Supreme, or Superior Cour; Court of Appeals;
Clerk of Court; OA; Legislator; Member, Counc of State)
Oves @No
“AFFIRMATION
1 have careful reviewed my most recently led Statement of Economic Interest Long Form and my responses continue
be true, correct, and complete to the best of my knowiedge ond beer
1 have not transferred, and wil ot transfer, any asst, interest, or property for the purpose of concealing it rom
closure while reining on equitable Interest
understand that my No Change Form is a publi record
have read and understand the folowing statutes:
N.C.G.5. § 138A-26. Concealing or fling to disclose materil informatie.
A fing person who knowingly conceals or knowingly fal o disclose Ifermation tha required to be disclosed
on Seaement of economic nierest shall be Quilty of 8 Class 1 misdemeanor and «subject to discpinary
Scion under G.5. 1308.45.
N.C.GS. § 138A-27. penalty for fale information.
A fling person who provides ele information on statement of econoric terest knowing that the
Information 1 ase. 1s ult of Clas felony and shll be subject disciplinary Scion under G.5. 1364-45.
2 affirm under penalty of perjury that the foregoing is true and correct.
. . ot 2-26-20%
Signatire Date
Alun to De ualbe due
Printed Name
‘Submit signed, original documents only. Do not fax or e-mail this form.
This document is » public record.
2023 Caldwell Community College & Technical Institute Trustees
Document text
. FoR STAFF USE ONLY
TEN s Date Reseed: i
Ga) TATE ETHICS COMMISSION
SASH 2023 STATEMENT OF ECONOMIC INTEREST RECEIVE
Slr ECEIVEL
SE No Change Form
This entire form must be completed to fulfill
your SEI filing obligation. ING ETHICS COMMISSION
Reason for Filing (Complete al thithppiy.)
TT Eevee 0 (Spec souncy and postion) | Board/Commissan (Lt he complete names of all State
Boer an when you are serving or are bong considered.)
Comat Coffs Tracts | Catdust omit lle Techie Jet
a ove 9: sii Officer in 3022 | Currently Serving or Serve 2s Cegiiator n 2022 (Speciy
Sonny Steer &. ode, rk of cour, district attorney.) House or Senate.)
AFFIRRATION
have corel reviewed my ms recenty fled Statement of Economic Interest Long Form ond my responses continue
amas, and complete to the bet of my knowledge and blir.
Lave not transferred, and wil not transfer, any asset, interes, or property fr the purpose of concealing I from
iaiosure whe retaining an equitable interest.
{understand that my No Change Form is public record.
have read and understand the folowing statutes:
N.C.0.5. § 1384-26. Concealing or fling to dscose material information.
A ing parson who knowingly conceals or knowingly falls to disse information tha s reared tbe disclosed
A ero assoc shall be Quy of 3 Class 1 misdemeanor and... subject to disilnary
Sei onder G5, 30A.35:
N.C.G.5. § 138427. Penalty for fais Information.
A ling person who provides fis information on a statement of economic terest... knowing that the
Ag pero Oe ra cine felony and shal be subject to disciplinary action under GS. 1384-45.
affirm under penalty of perjury that the foregoing i true and correct.
a, Wi [ pg-2/-2023
Signature Bate
NY 10:1)! Ford aulieidye
Printed Name
Submit signed, origina! documents only. Do not fax or e-mail this form
This document is a public record.
2022 Caldwell Community College & Technical Institute Trustees
Document text
pn TORSTAFE USE ONY
GT STATE ETHICS COMMISSION Date Received:
lr 2022 STATEMENT OF ECONOMIC INTEREST | RECEIVED
= No Change Form |
| APRO4 202
‘This entire form must be completed to fulfill t
your SEI filing obligation. NCETHICS COMMISSION
Fler's Name (Firs, Middle, Los)
Lie | Bui T Willie] | Doughtrdee [
Reason for Filing (Complete all that &pbly)
State Government Job (Speciy agency and postion.) | Boara/Cammision (List the complete names o al Sate
boards on which you are serving or are being considered)
Currently Serving as a Judicial Officer (Specify office.) Currently Serving as a Legislatod (Specify House or Senate.)
‘Are you a CANDIDATE fo & covered elected office? | | If Yes, specty offic and Distrc/County 1, applcabe:
(istrict Superior, or Supreme Court, Court of
Clerk of Courgy District Attorney, General Assembly)
Over bts
AFFIRMATION
1 have carefully reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue
10 be true, correct, and completa to th bast of my knowledge and belle.
Ihave not transferred, and wil not transer, any asset, ntarst, or property for the purpose of concealing It from
disclosure while retaining an equitable interest.
T understand that my No Change Form is a public record.
have read and understand the following statutes:
N.C.G.5. § 136A-26. Concealing or fang to disclose material information.
A fling person who knowingly conceals or knowingly falls to disclose information tht s required to be disclosed.
on a statement of economic Interest... shal be gully of a Clacs 1 misdemeanor and. subject to dscipnary
acon under GS. 138A-45.
NCGS. § 136A-27. Penalty for false information.
A fling person who provides fais Information on a statement of economic interest . . knowing that the
Information s fase Is uity of a Cass H felony and shal be subject t clscliary action under G.5. 1304-45.
Taff under penalty of parjury that the foregoing is true and correct.
Jo) | 03-23% 3p22-
Signatire i Date
Alay nlf Gord Daugfrdge.
rinted Name
‘Submit signed, original documents only. Do not fax or e-mail this form.
This document is a public record
2021 Caldwell Community College & Technical Institute Trustees
Document text
CE
Pa STATE ETHICS COMMISSION Gate Received
Go o8 |
(5p 2021 STATEMENT OF ECONOMIC INTEREST RECEIVED
R&I NO CHANGE FORM
APR 12 207
This entire form must be completed to fulfill
your SEI filing obligation. "
NCETHICS Coumssion
Fler's Nome (First, Middle, Lost)
prefix First Name Middle Name Lost Name Suffix
Mr. | Alvin Williford Daughtridge
State Government Job (Specly agency an postion) | Bom Commssn (Lt he mormtets rares of Ste |
= " | boards on which you are serving or are being considered.)
Caldwell Sommunity College & Technical
L Institute Board of Trustees
Judicial Offer (Spec office.) Leg sltor (speciy House or Senate.)
AFFIRMATION
have carefully revised my most recently filed Statement of Economic Interest Long Form and my responses continue
to be true, correct, and complete ta the best of my knowlege and BOIS!
1 have not transfered, and will nt transfer, any asset, interest, or propery fo the purpose of concealing it from
disclosure while retaining an equitable terest
understand that my No Change Form is pusiic record.
have read and understand the folowing statutes:
N.C.G.S. § 1384-26. Conccaling or failing to disclose material information
A fing person who knowingly conceals or knowingly fail to discise Information that is required to be disclosed
an a statement of economic interest . . shall be gulty of a Class 1 misdemeanor and . subject 5 dsclnany
action under G.5. 130A45,
N.C.G:S.§ 1384-27, Penalty for fie information.
fling person who provides false information on 8 atsment of economic Interest... knowing tht the
information i als i gully of a Class H felony and shall be Subject to isciinary action ander G.o. 1364-45,
Tatfirm under penalty of perjury that the foregoing is true and correct,
Er ——— Date
Mr Alvin Daughtridge
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form. i
This entire document is a public record.
2020 Caldwell Community College & Technical Institute Trustees
Document text
om FoR STAT GSE OT
SR STATE ETHICS COMMISSION De RISEN | EE
Gt 2 RECEIVED
8 alr Zi 2020 STATEMENT OF ECONOMIC INTEREST
2 NO CHANGE FORM MAR 16 2020
This entire form must be completed to fulfill NC ETHICS COMMISION
your SEI filing obligation. Greer OS Co
scones J{iLo_owe BAC “2
enteedinDB__by
CE ER I SS
Reason for Filing (Complete all that apply.)
State Government 395 (Spey agency and poston) | Board/ Commission (st 1h complete names of al Sate
boards on which you are serving or are being considered.)
|" Cattwell Community College and Technical nsttute
Board of Trustees
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
AFFIRMATION
1 have careful reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue
10 be tr, cotect, and complete to the bes of my knowiedge and bale.
1 have not transfered, and wil ot transfer, any asset, interest, o property for the purpose of conceaing it from
disclosure whi retaing an equitable interest
understand that my No Change Form is a public record
have read and understand th folowing statutes:
NCGS. § 1384-26. Conceaing o ailing to disclose material information
A fling person who knowingly concesis or knowingly ais o disclose Information that is required to be disclosed
ona Savement of CConMIE teres - shall be Gut of 8 Class misdemeanor and. Subject to dispinary
ction under G.5. 130A-35.
NCGS. § 138427. Penalty for fase information
A fling person who provides alse information on 3 statement of economic teres . . knowing that the
Information 1 ase 5 gulty of Clas felony and 3hall be UbJect 1 dscpiary action under G.5. 138A-45.
I affiem under penalty of perjury that the foregoing is true and correct.
os dh March 9, 2020
Signature [és Date
Ain W. Daughtridge
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
This entire document i a public record.
2019 Caldwell Community College & Technical Institute Trustees
Document text
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
STATE ETHICS COMMISSION
2019 STATEMENT OF ECONOMIC
INTEREST
This entire form must be completed to fulfill
your ethics filing obligation. ____ Checked for completion
____Scanned ______Date
Incomplete Qs ____ ____ ____ ____
Supp. sent date _______ by _____
Supp. received date _________
Entered in database ______ by ______
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Mr. Alvin Daughtridge
Current Employer Job Title
retired retired
Nature or Type of Business
Furniture manufacturer
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.)
Caldwell Community College Trustees
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
Judy Goble Daughtridge Spouse none none home maker
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
Property Interests
1. As of December 31, 2018, did you or any members of your immediate family:
A. have an ownership interest in North Carolina real estate (including your residence) with a market value of
$10,000 or more?
☒ Yes ☐ No
Owner of Real Estate % Ownership Interest Location by City Location by County
(Self plus Spouse) 100.00% lenoir Caldwell
B. lease or rent real estate or personal property to or from the State of North Carolina with a market value of
$10,000 or more?
☐ Yes ☒ No
Name of Lessor Name of Lessee
(Renter)
If Real Estate, Location
by City & County
If Personal Property,
Describe
2. At any time during 2017 or 2018, did you or any members of your immediate family sell to or buy from the State of
North Carolina personal property worth $10,000 or more?
☐ Yes ☒ No
Name of Purchaser Name of Seller Type of Property
The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10
Financial Interests
3. As of December 31, 2018, did you or any members of your immediate family own any of the following financial
interests valued at $10,000 or more? List each company individually.
A. Stock in a publicly owned company?
☐ Yes ☒ No
►Do not list interests in a widely held investment fund (including mutual funds, regulated investment companies, or
pension or deferred compensation plans) if:
1. the fund is publicly traded or its assets are widely diversified; and
2. neither you nor an immediate family member are able to control the underlying assets.
Owner of Interest Full Name of Company or ticker symbol
B. Stock options in a company or business?
☒ Yes ☐ No
Owner of Stock Option Full Name of Company (Do not use a ticker symbol)
Alvin Daughtridge (Self) Archer Daniel Midland
C. Interests in a non-publicly owned company or business entity? These include interests in sole proprietorships,
partnerships, limited partnerships, joint ventures, limited liability companies, limited liability partnerships, and
closely held corporations.
☐ Yes ☒ No - If “No,” proceed to question 4.
Owner of Interest Name of Company or Business Entity
C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the
names of any other companies or business entities in which the Primary Company owns securities or equity
interests valued at over $10,000, if known.
Non-Publicly Owned Company or Business Entity
(the Primary Company)
Other Companies in which the Primary Company
Owns Security or Equity Interests
None or Not Known
C (2). If you know that any entity listed in 3.C or 3.C(1) above has any material business dealings or business
contracts with the State of North Carolina, or is regulated by the State, briefly describe that business activity.
Name of Company or Business Entity Description of Business Activity with the State
None or Not Known
4. As of December 31, 2018, were you or any members of your immediate family the beneficiaries of a vested trust with
a value of $10,000 or more that you created, established, or controlled?
Do not list assets held in blind trusts. See 2019 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
☐ Yes ☒ No
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10
5. As of December 31, 2018, did you any members of your immediate family have liabilities of $10,000 or more, excluding
the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student loans,
personal loans and intra-family debt.
☐ Yes ☒ No
Name of Debtor Type of Creditor (commercial Bank, credit union,
individual, etc.)
6. List each source of income (not specific amounts) of more than $5,000 received by you or any members of your
immediate family during 2018. Include salary, wages, state/local government retirement income, professional fees,
honoraria, interest, dividends, rental income, business income, and other types required to be reported on State and
federal tax returns.
Do not include income received from the following sources:
► Capital gains ► Federal government retirement
► Military retirement ► Social security income/SSDI
Recipient of Income Name of Source Type of
Business/Industry
Type of Income
Alvin Daughtridge (Self) Fairfield Chair Company Furniture Manufacturer Salary
The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
Professional and Civic Relationships
7(a). During 2018, were you or any members of your immediate family a director, officer, governing board member,
employee, independent contractor, or registered lobbyist of a nonprofit corporation or organization operating in North
Carolina primarily for religious, charitable, scientific, literary, public health and safety, or educational purposes?
☐ Yes ☒ No - If “No,” proceed to question 8.
► Do not list State boards or entities.
► Do not list organizations of which you are a mere member.
Name of Person Position Name of Nonprofit
Corporation or Organization
Nature or
Purpose of Organization
7(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive
State funds, briefly describe the nature of that business, if known or with due diligence could reasonably be known.
Name of Nonprofit Corporation or Organization Describe State Business
None or Not Known
8. During 2018, were you or any members of your immediate family a director, officer, or governing board member of
any society, organization, or advocacy group with an interest in matters over which your agency or board may have
jurisdiction?
☒ Yes ☐ No ☐ Legislator/Judicial Officer - You are not required to complete this question if you are filing because
you are a legislator or judicial officer or you are filing as an appointee to one of those offices.
►Do not list organizations of which you are only a member and do not serve in a leadership role.
Caldwell Community College Trustees
Name of Person Name of Society, Organization,
or Advocacy Group
Leadership Position
(Director, Officer, Board Member)
Alvin Daughtridge (Self) Communities In Schools of Caldwell
County
Director
The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10
9(a). List the name of each business with which you were associated where you or a member of your immediate family
was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2018.
Name of Person Relationship to Filer Name of Company Role of Person
Alvin Daughtridge Self Fairfield Chair Company Officer - Vice President
9(b). If you know that any entity listed in 9(a) above had any material business dealings or business contracts with the
State of North Carolina or was regulated by the State as of December 31, 2018, briefly describe that activity.
Name of Company or Business Entity Description of Business Activity with the State
None or Not Known
10. Are you a practicing attorney?
☐ Yes ☒ No ☐ Judicial Officer/State Attorney
If “Yes”, check each category of legal representation in which you or the law firm with which you are affiliated has earned
legal fees of more than $10,000 during 2018.
☐ Administrative ☐ Admiralty ☐ Corporate ☐ Criminal
☐ Decedent’s Estates ☐ Environmental ☐ Insurance ☐ Labor
☐ Local Government ☐ Real Property ☐ Securities ☐ Tax
☐ Tort litigation (including
negligence)
☐ Utilities Regulation ☐ Other category not listed
11. During 2018, were you a licensed professional (other than an attorney) or did you provide consulting services
individually or as a member of a professional association for which you charged or were paid over $10,000?
☐ Yes ☒ No
Type of Business Nature of Services Rendered
The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10
12. Are you or your employer, or any members of your immediate family, or their employers currently:
licensed by the State board or agency with which you are or will be associated or
regulated by the State board or agency with which you are or will be associated or
in a business relationship with the State board or agency with which you are or will be associated?
☐ Yes ☒ No ☐ Legislator/Judicial Officer - You are not required to complete this question if you are filing because
you are a legislator or a judicial officer or you are filing as an appointee to one of those offices.
Name of Person Name of Employer
(if applicable)
Type of Relationship
(Licensing, Regulatory, Business)
13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal within the 12
months preceding your filing of this form?
☐ Yes ☒ No
Name of Lobbyist Lobbyist’s Principal Date of
Registration
Registration
Expiration
Other Disclosures
14. During 2018, after you were (1) appointed, (2) employed, or (3) filed or were nominated as a candidate, did you
receive any “gift(s)” exceeding $200 per quarter from a person or group of persons acting together,
when both you and those person(s) were outside North Carolina,
under circumstances that would lead a reasonable person to conclude the gifts were given for lobbying?
☐ Yes ☒ No
► Do not report gifts given by members of your extended family.
► Do not report gifts you have previously reported on the “Expense Report for Exempted Persons.”
Date Item Received Name and Address of Donor(s) Describe Item Received Estimated Market
Value
The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 10
15. During 2018, after you were (1) appointed, (2) employed, or (3) filed or were nominated as a candidate, did you
accept a “scholarship” exceeding $200 related to your public position from a person or group of persons acting
together,
when those person(s) were outside North Carolina?
A “scholarship” is a grant-in-aid, either direct or indirect, to attend a conference, meeting, or similar
event, including tuition, travel, lodging, meals, and other similar expenses.
☐ Yes ☒ No ☐ Judicial Officer - You are not required to complete this question if you are a judicial officer or you
are filing as a judicial officer appointee.
► Do not report gifts you have previously reported on the “Expense Report for Exempted Persons.”
► Legislators are not required to report scholarships paid by a nonpartisan legislative organization of which the legislator
or the General Assembly is a member, participant, or affiliate.
Date of
Scholarship
Name and Address of Donor(s) Describe Event Estimated Market
Value
16. Have you been appointed or considered for appointment to a covered board by the Governor or another Council of
State member?
Council of State members are:
► Governor ► Lt. Governor ► Secretary of State
► State Auditor ► State Treasurer ► Superintendent of Public Instruction
► Attorney General ► Commissioner of Agriculture ► Commissioner of Labor
► Commissioner of Insurance
☐ Yes ☒ No
If “Yes,” list all contributions you made in 2018 with a cumulative total of more than $1,000 to the Council
of State member who appointed you. Do not include contributions from immediate family members.
► Contributions are defined broadly in N.C.G.S. § 163A-1411(13) and include “any advance, conveyance, deposit,
distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value
whatsoever.”
Date Amount Contributed to
The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10
17. Are you an appointee or prospective appointee as:
a. the head of a principal state department (e.g., cabinet secretary) appointed by the
Governor; or
b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District
Court Judge; or
c. a member of any of the following boards:
ABC Commission
Coastal Resources Commission
State Board of Education
State Board of Elections
Division of Employment Security
Environmental Management Commission
Industrial Commission
Human Resources Commission
Rules Review Commission
Board of Transportation
UNC Board of Governors
Utilities Commission
Wildlife Resources Commission
☐ Yes ☒ No
If “No,” proceed to
question 18.
d. If so, were you appointed or are you being considered for appointment to that
position by a Council of State member?
☐ Yes ☒ No
If “No,” proceed to
question 18.
e. If so, you must indicate whether during 2018 you engaged in any of the following
activities with respect to or on behalf of the candidate or campaign committee of
the Council of State member who appointed you:
i. Collected contributions from multiple contributors, took possession of such
multiple contributions, and transferred or delivered those collected
contributions to the candidate or committee?
☐ Yes ☐ No
ii. Hosted a fundraiser at your residence or place of business? ☐ Yes ☐ No
iii. Volunteered for campaign-related activities, including phone banks, event
assistance, mailings, canvassing, surveying, or any other activity that advances
the campaign of a candidate? ☐ Yes ☐ No
18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon; or (ii) an order of
expungement?
☐ Yes ☒ No
Offense Date of Conviction County of Conviction State of Conviction
19. Are you aware of any other information that you believe may assist the Ethics Commission in advising you
concerning your compliance with the State Government Ethics Act?
☐ Yes ☒ No If yes, please provide that information below.
The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 10
Affirmation
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding
Unemancipated Children are public records.
I have read and understand the following statutes:
N.C.G.S. § 163A-191. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed
on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and subject to disciplinary
action under G.S. 163A-415.
N.C.G.S. § 163A-192. Penalty for false information.
A filing person who provides false information on a statement of economic interest . . . knowing that the
information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415.
I affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31,
2018, my responses continue to be true, correct, and complete to the best of my knowledge and belief.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 04/12/2019
Signature Date
Alvin Daughtridge
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2018 Caldwell Community College & Technical Institute Trustees
Document text
7%: NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY
JA"); ELECTIONS AND ETHICS ENFORCEMENT ate Received:
VA} 2018 STATEMENT OF ECONOMIC INTEREST
BEAR -9 PH 8:25
919-814-3600 whw.ncsbe. gov/Ethics/SET Jo)
(7 checkes for completion
THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL Comes Ulloove
YOUR SEI FILING OBLIGATION Iomplete ts —
Supp. SentOote ____ By___
Supp. Received Oe.
Entered in dotanase or
FILER'S NAME (FIRST, MIDDLE, LAST)
"NATURE OR TYPE OF BUSINESS
= urn: May ufocture,
REASON FOR FILING (COMPLETE ALL THAT APPLY)
‘STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (Lst complete name of al State
boards on which you are serving or ae being considered)
Thustee
avd Technical” Ihstitute
JUDICIAL OFFICER (Spec Office) LEGISLATOR (Specify House or Senate)
A. Do other immediate family members reside in your household?
®ves Oto
When used throughout ths form, the term Immediate family includes your spouse (unless legally separated). It also
Includes members of Your extended family (your and your spouse’ 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 s a chid under 18 years ol.
Minors are emancipated by marrage, enlistment in the US miltary, o court order for emancipation.
EMANCIPATED MINORS BUSINESS
[Buby G Dawabteidyd Spans | Mom | mowe
The SEX and any attachments, excluding the Confidential Form, are public records. Page 1of10
List ONLY tha Initials of all unemancipated minors in your household below, A minor s 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
MINORS
PROPERTY INTERESTS
1. AS of December 31. 2017, 4d 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?
Kes Ono
[om ose] soem ret [_ tsi __]_iactinbrcovty_|
B. Lease or rent real estate o personal property 10 ar from the State of Nort Carolina with a market value of
$10,000 or more?
ves ®No
Name of Lessee | If Real Estate, Location | If Personal Property,
Renter) by City & County Describe,
2. At any tme during 2016 or 2017, dd you, your spouse, or members of your immediate family sell to or buy from the
State of horth Carolina personal property with a market value of $10,000 or more?
Oves (no
[ tameotpuchmer | wameorseler | weorvropeny |
The SEX and any attachments, excluding the Confidential Form, are public records. Page20f10
interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY.
A. Stock in a publicly owned company?
[ ownerofmterest | rullNameof company (Do not use a ticker symbol) |
Proctor + Gamble Co
TT a Te
Oves ®ro
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
Owner of Interest
C (1). For each non-publicly owned company or business entity (the “primary company”) identified in question
CL
EET TR,
ESS —— poo
Sa Boas Ra TT
4. As of December 31, 2017, were you, your spouse, or members of your immediate family the beneficiaries of a vested
Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust,”
DYes Bno
aves Asie ar romes | escpioro mr | vas nesioni oh Tt
5. As of December 31, 2017, did you, your spouse, or members of your immediate family have liabilities of $10,000 or
OYes [No
Name of Debtor (You, Spouse, Immediate Family “Type of Creditor (Commercial Bank, Credit Union,
So Cm
6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of
ntti mie TEA HO oi see
Semaine rotor |
Sr — igh
Recipient of Income Type of Type of Income
PE nur
RA ] EE A RAN
Th 51a ey ascents acing te Conde Form are pubic records regesarso
7(a). During 2017, were you, your spouse or members of your immediate family a director, officer, governing board
PA¥es [INo- If "No," proceed to question 8.
EE
En [TEE
A
CJ None or Not Known
8. During 2017, were you, your spouse, or members of your [Immediate family a director, officer, or governing board
OiYes [No [Legisiator/udicial Officer - You are not required to complete this question if you are filing because
EE | EET
ea ——————. Sot
[ omeatreron | mamionap wri | tamstconpany | sawrrensn |
9(b). If you know that any company or business entity listed in 9(a) above had any material business dealings or
= EY I AN
Des wo [Judicial Officer/State Attorney
legal fees of more than $10,000 during 2017.
Fv Grammar rs— Som
[J Decedent's Estates. [J Environmental [Insurance Labor
[0 Local Government [J Real Property [J Securities. OTax
OYes [BNo
EY TT RE
55 ay aca, ssn obit om nu rasario
+ Have a business relationship with the State board or ‘employing entity with which you are or will be associated?
DOYes XNo []Legislator/udicial Officer - You are not required to complete this question if you are filing because
OYes ®No
« accept a “scholarship” exceeding $200 from a person or group of persons acting together 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
ns ort
C3 ¥es No [Judicial Officer - You are not required to complete this question if you are a Judicial officer or you are
er we
+ tt o——
QOYes ®No
tists OT altel ania ated 627 wih sete
LN conotons fou (CT imeem ber) made dri 2017 with
deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value
whatsoever,”
TT [Ee
0% No contribution(s) with a cumulative total of more than $1,000
St ny stamens acing the Conn Form, rs utc cars resorio
[17 ave you sm appates or prospecive sppames
i 2. the head of 2 principal state department (e.g. cabinet secretary) appointed by the |
b. a orth Crain Supreme our Justice, Cour of Apes, Super o Dt
Eis
. a member of nyo th following brs:
Pi
Cool Resourees Commission
+ State Board of Education CiYes {No
toe Bord of Echne
Dano Employer Securty Wo proceed to
Enironarial Managemen Comision esion 15.
bia
~ Human Recoaes Commision
Rl Revow Commision
Sood of Tamspoaton
NC Son of verrrs
~ Uities Comision )
* Wide nesogees Commission
d. If so, were you appointed or are you being considered for appointment to that [Yes [No
public positon by a Council of State member? Council of State members are sted | zr no,” proceed to
In question 16. question 18.
oso, you st cats whthr during 2017 you (ra mite fry
Iran ar) Shope aw of he Storia wi espero on bal of
oe ana op capa soi of he Counc of Stare mrmier whe
sama you ou pov poo
I. Clucted comutions from lil contutars ok possession of such
le comratans on onlored ot devel ch cteced
Comition ote cna or comes Comtonons re suined n
asian Ser
ost ondraer ot your eer o plac o buses? ove Ov |
Wh Voluteeed for camplgrelted act, which cle, 5 ar Po ed
J A A TA
Toray tava na?
6. ive you ever been comic of a oy fo which you hve not ecened airs (13 paren of cance or (97
ier of expunge: garg ht coitons
Oves [No
[oes | oweotconvicion | Cowmworcomicion | sete of conviction
15 re you aware of av over oration ht you Ble ay 259 the Sate Es Comission avg you
Corea our compas wh re Ste Soon Ee
ves (No Ifyes, please provide such Information below.
The SEX and any attachments, excluding the Confidential Form, are public records. Pagesotio
AFFIRMATION
+ aff that the information provided nts Statement of Economic Interest and any atachments hereto sr ru, complet,
and accurate othe bet of my knowledge and belief.
also certify that have not transfered, and will not raster, any asst, rest, o property fr the purpose of concealing it
from disclosure while retaining an equitable intrest
1 understand that my Statement of Economic Interest and any attachments o supplements thereto (ith the exception ofthe
Confidential Form regarding Unemancipated Children) are publi record
acknowledge tha 1 have ead and understand N.C G.. 1384-26 regarding concealing o fling o disclose matrisl
information and N.C.G.5. 1384-27 regrding providing use information
§ 138.26, Concealin o fling 0 disclose material information.
A filing person who knowingly conceals o knowingly ils o disclose nformtion that is required tobe disclosed
ona statement of economic ners! under tis Arce shal be ui ofa Class | misdemeanor and shal be subject
‘odiscplinary action under G.S. 138445.
§ 1384.27, Penalty for false information
A fling person who provides fase information ona siatement of economic interest a required under tis Acie
knowing that the information i ase fs ity ofa Cas H felony and shall be subject to disciplinary action under
G5. 138A45.
ir Wi Mf T . id 4 201%
Signature Ba
Boia Williford Dasghteidge
Printed Rame
Submit SIGNED, ORIGINAL documents only. 0 not fax or email this form.
The SEX and any attachments, excluding the Confidential Form, are public records. Page 100f 10
2017 Caldwell Community College & Technical Institute Trustees
Document text
74s, NORTH CAROLINA STATE ETHICS COMMISSION | rox cute comassion se on
xn pl 2017 STATEMENT OF ECONOMIC INTEREST | Otc keceves
919-814-3600 ww. ethicscommission. nc. gov
THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL i erases ton omen
YOUR SEI FILING OBLIGATION seonned we
ncompee BE |
Sup. Senn vate 11%] | oy 2.
Supp. Receives oe 24] |
Entered in database 7/2 By £Y
FILER'S NAME (FIRST, MIDDLE, LAST) _
Prefix | First Name Middle Name | Lost Name _ B - suttix
Me, | Row | Willi§ord pe tecdge n
CURRENT EMPLOYER _ os ime —
: eld Chaic Company _ vi esidont
NATURE OR TPE OF BUSINESS / B
Eucnture Mopufocturer
REASON FOR FILING (COMPLETE ALL THAT APPLY) oo B
STATE GOVERNMENT 108 (Spec Agency) BOARD/COMMISSION (List complete name of all State
. | boards an which you sre serving or are being consider
Trustee a
Cardo Community College ong
JUDICIAL OFFICER (Specty Office) LEGISLATOR (Spey House or Senate) _
A. Do other immediate family members reside in your household?
Oves Do
Wien used throughout this form, the term Immediate family includes your spouse (unless legally ssparate. Tt also
includes members of your extended family (your and your spouse's chIdren, orandcnkiren, parents, orandoarents, and
Siblings, and the spouses of cach of those parsons) who reside in your household.
List the full name of al adults and emancipated minors in your household. A minor is a hid under 18 years od. |
Minors are emancipated by marrage, cntment n the US miliary, or court order for smancivaton
FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER 108 TITLE NATURE OF
EMANCIPATED MINORS - _ mt ‘BUSINESS
Fads 6 Daughter Spouse aowe | wowe one
The SEI and any attachments, excluding the Confidential Form, are public records. Page 10110
—
/B. List ONLY the initials of oll unemancipated minors n your household below. A minor 1s a hid under 16 years ol.
Note: You must list the full name of each minor child on the Confidential Form available at the
end of this document.
INITIALS FOR | RELATIONSHIP. EMPLOYER 108 TITLE
UNEMANCIPATED
“ianors © | ll
PROPERTY INTERESTS
1 As of Desamber 31, 2016, 00 you, your spouse, or members of your Immediate family:
A. Have an ownership interest in forth Carolin reat estate (including your residence) with a market value of
510,000 or mores
Cves Ono
ownerot memes | sw ounen ren | oan vy cy
AL vin Tu Yitcise 10075.) Lewoin, Ne 28s” (oldie
8. Lease or rent rea estate or personal property 0. rom (he State of North Carolin witha market value of
$10,000 or mores !
Oves @no
Name of Lessor Name of Lessee | 1f Real Estate, Location | If Personal Property,
‘ Renter | oy citys County "Describe
|
2. A any time during 2015 or 2016, you, your Spouse, or members of your Immediate family sll {0.0 buy from he
State of North Caroling persenal property wih a market valve f $10,000 or march
Oves no
Name of Purchaser Name of Seller [typeof propeny
The SEI and any attachments, excluding the Confidential Form, are public records. Page 20 10
[Financiat INTERESTS
3. As of December 31, 2016, 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?
ves Cite EE
50 Tot In owners Eres 3 Wey Bed Tester urd (ding Tua ands, pueden
Compoita, o pension or defered compensatn pane i: (1) ine ond 1 PUBIC waded 7 1 seers re widely
Gores and iy nether You nr 3h madats Family het are al t Com) th assets held ie mutual
Investment company: of pension a deferred compensation pan.
Owner of interest Full Name of Company (0a not use a ticker symbol)
ia oil lifard Da n A ple Lc _
ee err———re—rre—————— Copa je. Finimcial
ee CeCemCola lo,
oo Prod e
IE cpl Bonk Cd_tenfieal Que
See @ 3 ATHT GNe
LIE | Duke Energy Corp Ned
B. Stock Options in a pany or business?
Oves [No
AL ;
‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol)
ewmorsoscowir Tron tame st Soman to not ween eter symbol)
C. oest 1a or-aublicl awed company or wenass nity (nding ares sol papers, |
arnaraips, Tad artaeshos, J venues, a Logit Companies, ited 10S porneroHs, and
Coven nls corporations
Des [JNo- If "No," proceed to question 4.
" Owner of Taterest — Name of Company or Business Entity
C1). For cach non-publicy owned company or busines: entity (the “primary company”) identified in question
SE aves east vot thc mares or ao et Sora of Sess ove whch oe TY Sop
Nan-Publicty Owned Company or Business Entity | _ Other Companies in which the Primary Company
PE ve Primary Company) oh Security or Equity Interests
Cone or ot Known
The SEX and any attachments, excluding the Confidential Form, are public records. Page 30110
€ (2). If you know that any company or business entity listed in 3.C or 3.C(1) above has any material business |
denings or business contacts with the Sate of North Carona, o 1s reguaied by the Sate, provide a brie |
escntion of thot buses act
Nome of Company or Business Entity Description of Business Activity with the State
None or Not known
r———— ————————————
4.” As of Decamber 31, 2016, were yo, your spouse, o members of your Ipmedite fry the beneficiaries of a vested
rus wih 3 vata SF 10,000 or more hot wos crave, Ean, or ComTGHed ou
Do not list assets held in blind trusts. See 2017 SEI Helpful Tios for the definition of "Vested Trust” and "Blind Trust.”
Oves [A No.
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
5. As of December 31, 2016, did you, your spouse, or members of your immediate family have liabilities of $10,000 or
more, exculig the mortgage: on your Dimory bers residence’ Examples mciuds cred ard debs, aut oars, Hudent
ioans, personal loans and miso amy deb
Ove gino
Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union,
Member) “ Lndividun, ete)
6. Lit each sours of income (nt specific amounts) of mors. han $5,000 received by you, your spouse, or members of
your immediate fami dura 2016. Include Slay, Wages, Ste/oca government. retnement, rofesciona fees
Ronorars, ere, Aidends, renal Income, business come, an oLhr Yet of Come ured 16 be reported on your
State and feral tx roars
Do ot include income received from the folowing sources:
» Capital gains » Federal government ratirement
> Miltary retivement » Social security income/ SSD
Recipient of Income Name of Source Type of Type of Income
Baines Industry
11 nad m0 reportabe income aver 35,000 n 2016. ~
Fama tame .
The SEX and any attachments, excluding the Confidential Form, are public records. Page dor 10
| PROFESSIONAL AND CIVIC RELATIONSHIPS
7(a). During 2016. were you, your spouse or members of your immediate family a director, officer, governing board |
| mame Eos rapist reso Or a TL dr of, gover word
| re Site of rin ra prima fo els arab sen, a, Bo an a 2PT09
pubic
LR T—
5 To Site bord rare, o eves ed by 3 oe SRA
Dont trp fw ou mr mee
Ah
Nam of Pesan | Wafer oshion | ___ Name of Nargrat | ature of Busmass or
Cormmraner Orpmton | Puasens or ese
— — 18 aoe of romain
Ohio to Dun dbstee Bond irssston | 7 Eilat frat "Fis nn
% ;
707 11h sorts cororaton or gaan ted ane G0 woes wR fh Sve of orth Cons o eve
Se nt, eas Brands» oo See oe re res ra a rh Corl or eve |
placate
Name of Nonprofit Corporation or organization Describe Sats Business or Site Faming
Ton oot Kran
0 de Ta £.
8. During 2016, were you, your spouse, or members of your immediate family a director, officer, or governing board
erat Scents ou rr a mr Er Sr
erates
[ves 20 (J Legislator Judicial Officer - You are not required to complete this question if you are filing because
a es Sas comes the austen your pig
0 nt crpacatons of which ou re aly. member (rt sung in esr rl),
Name at person | Name of Society, orgrrastion rer —
ot rove one recess Steen sosnd member
The SEX and any attachment, excluding the Confident Frm, are public ecards. Page serio
9(a). Ls the name of each company o business ith Which vou were associated where you or member of your inedats |
family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2016. |
Name of Person | Relationship to Fler | Nam of Company Rol of person
| No Business Associations
CI eens reper
Rn Foi J LP
oludbal sy leiimicee | VP
fim Pe “psi ]
— Jou kr Tat oy company or business erty sed (0) ove Tad any tel business eons o
nes Contras wih he State Of Nort Cvolin o wok Gad tn Ste of Dec Sh ores |
re asco of ht Busnes sen.
Nome of Company or Business Entity | Description of Business Activity with he Sate
Ct potable (ho ees td on 2501
Cl¥es [No [Judicial Offcer/State Attorney |
legal fees of more than $10,000 during 2016. _
J Administrative 0) Admiralty [J Corporate J Criminal
oecedents ates Er— nrc Duaser
[0 Local Government [0 real Property [J securities OTax
OTe itoaton (ncudig (vite Regulation C) thr category nt hte
frais
LL Dung 016, ware you a arses oats (other than 1 sore) ar 4 you provas cori rvs
Inihaly Br 3 mero rtecin ssoaaton fr heh ou hae werd Geer 0008
Ove gino
i — Nature of Services Rendered
The SEL and any attachments, excluding the Confidential Farm, are public records. Page gor 10
12. Ae ou o your employes, your spause of members of your immediate amily, or ther employer caren:
+ Lanse by the State baad a employing entity with whch you are or il be sociated or
Reulted by th State beard or employing entity wih which ou ar ar wil be associated or
+ Have busines rGDSD wh the State board or employing entity with whch you ae wl be associated?
Oves fe [J Legislator/Judicial Officer - You are not required to complete this question If you are filing because
you are a leita ora Juda officer (Judi fier 5 deinen te SE) Heil Tt) op
7c ing 03 applnec tha aces
Name of Person Name of Employer Type of Relationship
i appicabie) icensing, Regulatory, Business)
£3. Are vou, your spouse or 3 member of your mmedlate family curently registered 25 oboyat o obo pine] or
were you registered as such within the 12 months preceding your filing of this form? |
Oves fro 4
Name of Lobbyist Lobbyists princiosl | ate or Registration
Registration | Expiration
Tn | Cooter” |
BE HS A —
OTHERDISCLOSURES SO |
1, Dur on coledar quar n 016 (su nly the tne period ae you were spponed, alors or fed or ware |
nominated 36 candidate, 4 you
+ receive any "(s)" xceeding 5200 pe quarter fom a perso or group of persons acting together, and |
+ When ba you and tose persan(s) wer ouside North Carlin ot he tm you cepted he ihe) an
* fie SAL wre vn nde cumstances at wed 1d 3 resonate person o Senet hy ers ove |
for obying?
Oves No. |
5 nc por ots given by meres of your EIST Ty
»00 not port Gifts ht have previously been reported by you o the Deparment of the Secretary of State o th |
“Ecpanse report or Exempt ersons
Date Item Received | Nome and Address of Donor(s) | Describe tem Received | Estimated market |
Value
TT —
A _
The SEL and any attachments, excluding the Confidential Form, are public records. Page 70f10
—
15. During 2016 (but only the time period after you were appointed, employed, or filed or were nominated 2s a candidate) |
dav |
Spt scholars” exceeding $200 om perso group of persons cng tosh and
+ those person(s) were outside North Carolina and |
+ 10 scholarship was read 10 Your UB poston? A schelarshp® i. grant. in-ai,sther direct or indirect, |
£0"stend a Conterance, meetin, oF Grin evens nludng Slt wove may ee of indrect
similar expenses. |
Yes Io [Judicial Officer - You are not requir to complete ths question if you ae a sua officer or you are |
bdniuiabiiade ui Skit
]
> 00 10 ert its st hve reviusly ben ert by you th Department fhe Secretary of State an |
“Expense Report for Exempted Persons.” |
> Legiatos ar not requred report chlorsh pid by nonpartisan gst rgarizatn of whch the gtr |
oh Gare) Aerio a meron o aTCBaL oon ho of tn mn |
Date of Name and Address of Donor(s) Describe Event Estimated Market |
scorns | Vet
oo ST —+ EE B—
| |
Counc of Sone memes
Council of State members are: |
> Governor >t Govern » Sccrstary o ste |
» Sate Auer > Ste Treasurer > Supsrtendan of bic Inston
» Atorey Genera » Commissioner of Aycture Commissioner of ar |
» Commissiner of nsrance
Ove gre |
If "Yes", list all contributions you (NOT immediate family members) made during 2016 with a cumulative
Total of more then $1,000 1 the Govern a otmer Coun of Sees ame so ASL with ac |
ER
LC A 0 rst tt ts se cr, |
ego, Gunn, are of fund, oan, mens, oe or sobs of mar iy
whatsoever,”
ee
ome | amem | Contibued te |
combats win cums rato mars am 3.000 1
1 —]— 1]
1
A EE
The SEI and any attachments, axcuding the Confidential Form, are public records. Pagesotio
17 Ar you a1 sponte o prospective sppomee
2 he ead of 3 rina sae deparimen eg abt Secretar) sppoted by th !
Govern on |
b. Norn Carola Supreme Court tice, Court of Appa, Superior isnt
[ri |
| orem amie mgs
ac Commasn
| + Coostal Resources Commission |
+ State Board of Education Cves Kino !
| Sena oes |
| Dimon ot Empormens secur Wor proceed to)
~ Ennronnenta anagem: Commision Gestion 18.
| om common I
* Haman Rescues Commission |
| Bomor Tarsgoriaton |
| + UNC Board of Governors
| _ + wie resources Commission _ B
51 3m, were you sported or av you beng condos fo sppanment wht | Ives Cie 1
ln SC of Se mar Coun of Ste memos re 565 | 3 oceed te
Woven 16. fl
© 10. you must mate whether rng 2016 yea rt immed oly 1
IETS) nga ay ofthe folong Sctcs wi epee to on bh of i
he amine camp commas of Counc of menor oh
Some ou you aml poor
Oves Ono
I Colles contbutons om mole contutors ok possession of sch
rie ombon, 95d ares o Steed ho heed
contributions to the candidate or committee? Contributions are defined in |
eon 15.
in Hosted a fundraiser at your residence or place of business? CYes ONo |
ii. Volunteered for campaign-related activities, which include, but are not limited |
To, Shon Eth, int stance, mans, crunesn, veg, o om © |CI¥es [No
her ay hs evar he Campa of 5 cameo |
1. Have you ver ben conve of lon fo ch you hve not received ar (1) pardon of moan or 797 |
oir expungemen eqns ok conan |
Ove no
ortense Date of Conviction | _ County of Conviction | _ State of conviction
— RU N— —
15 Ar you aware ofa ier foratn ht a eee may st th State 5ncs Commision sowing vou |
Coan you compan wih he Sake Coven ones Se
Dives (fo if yes, please praia such informatio below. |
The SEL and any attachments, excluding the Confidential Form, ae public records. Page var 0
AFFIRMATION 1
—_—
| aff that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete,
[rr eof mowlcdge and ble |
| alsa certify that | have not transferred, and will not transfer, any asset, interest, of property for the purpose of concealing it |
| from disclosure while retaining an equitable interest. 1
| undesan hat my Stent o Economic res nd any sichments or spleens hereto (with the exception af he. |
| Confidential Form regarding Unemancpated Children) are public record i
information nd N.C G.5, 1334-27 regarding providing fle formation |
| A filme person ho knowingly concals o knowingly il disclose information hats required to be disclosed
| onc of cconomic iret ude 1s Arle sll be uy of ACh 1 midcom and ll he wc |
| to disciplinary action under G.S. 1387-45.
§ 136A-27. Peraty for fils information. i
A lng person who provides fs infomation on scent of conic rst equi under is Arle |
Knowing that he information is fis gly of 8 Class H felony nd shall be sujet fo disciplinary acon onder |
GS. 155A
Drage Ao. |
Abie 010d T 12 i 7.2017 |
Siomature f Bote !
illite litrid
Printed Name |
Submit SIGNED, ORIGINAL documents only. Da nt fax or mail tis form. . |
The SEX and any attachments, excluding the Confidential Form, are public records. Page 100r10
ei Duos Praclamtial Forametal due
Royal Datel Shel Ple-pok A
waltfeven Shee RIET
Houapdl Jntfonsdiona] hee
wd Carey Ine
“lnebar- Danilo Medlend Co
dsm aonal Taper. J
Prpeics. dncorpoal
Romge Ruawoncl ep
Jud {bork q (Gmenice
hi: PO Verieon Comm umiachons
ota Judy Southart Company
reps aomplehd 4-7-2017
Pog 191
For Office Use Only
vo NORTH CAROLINA STATE ETHICS COMMISSION
Es SUPPLEMENT TO THE RECEIVED APR 2 4 2017
~ 2017 STATEMENT OF ECONOMIC INTEREST
Name of Person Filing Supplement: A (w/w &. 7) po ugh Fe dlge
Name of Agency or Board: fcewTL
oat: EE NAAR
FINANCIAL INTERESTS or
C. Interest in 2 non-publicy owned company or business entity (including interests In soe proprietorship,
partnerships, limited partnerships, joint ventures, limited liability companies, limited liability partnerships, and
closely held corporations)?
[Yes [fo If No,” proceed to question 4.
Owner of Interest Name of Company or Business Entity
AFFIRMATION
| afi ha the information provided n his Statement of Economie Interest and ny attachments hereto are rue, complete,
and accurate to the best of my knowledge and belief.
also certify that | have not transferred, and will not transfer, any asset, interest, of 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 or supplements thereto (with the exception of the
Confidential Form regarding Unemancipated Children) are public record.
Iacknowledge that 1 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
statement of conor under this Acie shall be gy of Clas | misma and shall be sujet 10
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
G5. 134A.
[AT Agree
_ tw. 7 ’ 2 4-5 20s
Signature — te Date 7
2 4 A . Ral
Frintod Name
Submit SIGNED, ORIGINAL documents only. Do not fax o emall this orm.
This entire document and any attachments are public record.
2016 Caldwell Community College & Technical Institute Trustees
Document text
a) NORTH CAROLINA STATE ETHICS COMMISSION | ros enics commission use ony
iH Pr 2016 STATEMENT OF ECONOMIC INTEREST Date Received.
_ [pez =e v3
919-614-3600 ww eticscommission.ne.gov. | 1 : 0
THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL o Sancind to conssiotin
YOUR SEI FILING OBLIGATION [sms oe
| Supp. Sent Date __ La
[Fens nave einsr, mooie, st) ~ —]
prefix | First Name [eae yor Last Name Jsutr_
Meo | Rio | owilliford Docabitaidge _
CURRENT EMPLOYER R weTmE - oo
| NATURE On Tv OF BUSHESS A 1
[Euwendoce Momefrobomen LL
| EASON FoR FLING (SELECT ALL THAT APP)
STATE GOVERNMENT 103 (Please specs the mercy | C1E0ARD) COMMISSION (Fee it complete name of al
for which you work or are being considered) ‘State boards on which you are serving or are being.
hihi tui considereay ~~" |
Trusles i ei
Aatdu fl, Jommun oy
J OFFICER (asa specty th fc you le) | CJ LEGISLATOR (Please spe House or Senate) ]
A. Do other Immediate Family members resice in your housenoid?
ives Oto
When used througout ts orm, the erm Immediate Family nudes your spouse (ules legally seporated) It also
Includes membors of our Exendes {amy your an your ones cnn, Sani dren Ponts Siporont,
Slings, and te $5005E5 of each of tres ersonss wh reside your heusehold.
[Ce he ll nam fait dls emancipated mina + your nose A ivr 3 nid ander 16 you 94. |
Pinar rs emancipate by marrings: eneiment th US mir br ce rte Fo arancpatin
FULL NAME OF ADULTS & | RELATIONSHIP EMPLOYER 308 TITLE NATURE OF
| "eriancipareo winons |" i. SUstness
Jud G Dau frie. Zoo Nowe Neve | Nome
EIS i
The SEX and any attachments, excluding the Confidential Farm, are public records. Page 10f 10
B. List ONLY the initials of ol unemancipated minors in your household below. A minor fs a child under 18 years
old. Minors re emancipated by mariage, enlsument In the US miltary or court oder for emancipation
Note: You must list the full name of each minor child on the Confidential Form available at the
end of this document. oo —
INITIALS FOR | RELATIONSHIP ewpioven | sosTme ATURE OF
UNEMANCIPATED | BUSINESS
JTC EE SN i
i
— —
PROPERTY INTERESTS
1. As of Desember 31, 2015, dd you, your spouse, or members of your immediate fomiy.
A. Mave an ownership terest in North Carolin real estate (including your residence) with a morket value of
| Si0,000 or mores
Dves Ono
Owner of Real Estate | % Ownership Interest | Location by City Location by County
ITT AR ET Se EE rr]
[AT ud buf 3] wed Lemon NC 1 Caldas |
tony Baudet 257, Rocky mond Ne | Edsgeomb |
5, Lease or rent realestate o personal property 1a from the State of Nath Carlo with @ marke value of
$10,000 or more?
Oves [ino
Nome of Lessor Name of Lessee | If Real Estate, Location | Xf Personal Property, |
(Renter) by City & County Descrine.
1
2. At any time during 2014 ar 2015, id you, your spouse, or members of your immediate family sell or buy from he |
Sate of North Carolina personal property with a market vai of $10,000 or more
=
I Nome of Purchaser Nemoot seller i} Type of Property
The SEX and any attachments, excluding the Confidential Form, are public records. Page 20110
|FnaNcIAL INTERESTS
3. As of December 31, 2015, 0c you, your spouse, er members of your maiediate family own any of the following financial
Interests valued a $10,000 or more?
A. Stack in a publicly owned company? {
JO LL ——— _—_
+00 not Ist ovinership terest in 3 widely HOE Iveatment und (ciding mutual fands, regulated investment
companies, or pension of eferred compentation plans) I: () the fund Is publicly traded or ts assets are widely
ierafied; and (1) neither you nor an immediate. omy member are abi to control the assets ld n the mutual fund,
| investment company, or pension o dere compervation pian.
[ Owner of Interest Full Name of Company (Do not use a ticker symbol)
EE Vradeplol Yinagenl Ine
ean Webld ewer due Rect N |
— Cocu-Cole £0 J
ig] Nee attached Shesf Raya Bank Cda fod Cue)
Is in a company or business? ol
|
ves Eno 1
[ Owner of Stack Option Full Name of Company (Do not use a ticker symbol) |
C. Iterests m2 non-publaly cued company or business cathy (including Interests n sole praprictorships, 1
Barner, IMG Gainers, ont ventures, mies Ib companies, miter ably parinershss, and
Glsely held corporations)? |
[Yes []No- If "No," proceed to question 4.
Owner of Interest Name of Company or Business Entity a
Poin Inter) © rtrd Double ema g |
bo Prloi Dawspindge Dowshitroqe Foemalle
C (1). For each non-publicly owned company or business entity (the “primary company”) Identified in question
51 hove, pieace It the names of ny othe comaanes 1 Busia ents in which the primary company
vin Secures or equity interests valued at over $10,000, # known. |
Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company
(the primary Company) Owns Security or Equity Interests
(RNore or Nat Known
—
The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10
JE — — _
€ (2). 1f you know that any company or business entity listed in 3.C or 3.C(1) 2bove has any material business |
Gialngs or business cores 1th the Sate of Nor Caran, or requited dy the Ses, provide ori
description of that business activity. |
Name of Company or Business Entity Description of Business Activity with the State
| dane or tos known
4. As of December 21,2015, wero you, your Spouse, or members of your Immediate ami the benaficaes of a vested
ust wih 3 aloe OF $10.000 or mare Int was created, eSabiened, or controled by your
Do not list assets held in blind trusts. See 2016 SEI Helpful Tips for the definition of “Vested Trust” and "Blind Trust.”
Ove gho
© Name and Address of Tustes | __ Description of the Trust Vour Relationship to the Trust
| S. As of December 31, 2015, 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 loons ond nia. fami Geb.
| Ove aro
| Name of Debtor (Yau, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union,
1 ember) Individua, ete)
[
6. List each source of income (not spacific amounts) of more than $5,000 received by you, your spouse, or members of |
your immediate family during 2015. Include salary, wages, state/local government retirement, professional fees, |
Honor, terest, aiencs, Fntal income, Busines Income, 3nd other types of Income Toque to b reported on you |
State and federal to rotrns
|
Do got include income received from the following sources:
» Capital gains » Federal government retirement
> Military retirement > Social security income/SSD1
Lr Wayans * Sods sw SE —
i Recipient of Income Name of Source Type of Type of Income
| Ream! Business/ Industry
| C11 had no reportable income over $5,000 in 2015. RN
The SET and any attachments, excluding the Confidential Form, are public records. Page dor 10
PROFESSIONAL AND CIVIC RELATIONSHIPS
| 7(@). During 2015, were you, your spouse or members of your immediate, family a director, officer, governing board
member, employee, indepandent contractor, or registered lobbyict of 8 nOnPri corporation a rganizatn operating in
the State of North Carolina marily for religious, charitable, scientific, Morar, public health and safety, <r educational
[prose
CIYes [IN - "Ho, proceed to question 8.
|» Do not it State boards or entities, or entities created by a political subdivision of the State. oo 1
> 05 not list organizations of which you are a mere member - i
Name of Person His/Mer Position Name of Nonprofit | Nature of Business or
! - Corporation or Organization | Purpose of Organization
Woon lf Fede Poon Choa | of Cebu dl Coundy a fiana.
| fs 0. ae Truster Coldusll Commune ly Eee Efuicabrin |
LC 1 FE roma A
State funds, pleace provide brief description of the nature of that busines, If Known or with which due diigence coud |
reasonably be known.
| C1 None or hot known
[€ = Dd Mp | eben _ |
[- ——— L = - Tr -
During F015, wero you, your Spouse, or members of your {mediate family a director, officer, of Governg board
member of any Society, organization, or advocacy group with an interest in matters over which your agency or board may
nove jonadiction?
| Des KfNo Cogito uc Offer - You are not ruled to complete his aueston you ae lng because |
| vou are a legislator or 3 Judicial officer o you are ing as an appoint o those ofices
Name of Person Name of Society, Organization Leadership position
or Advocacy Group. | (oirector, officer, Board Member) 1
The SEX and any attachments, excluding the Confidential Form, are public records. Pages or 10
(a). List the name of each company or business with which you were associated where you or member of your Immediate
family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2015.
| Name of person Relationship to Filer Name of Company Role of Person
| (7 ho Business Associations = 1 No, proceed to question 10
CoG Eee |e ra
| Eas ¥ aif Fuirfeid Bauen | Loce feqonlont
| |
900). 1 you know that any company or business entity sted In 9(n) 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, 2015, provide &
| Brief Gescription of that business actu.
Name of Company or Business Entity Description of Business Activity with the State
CI Mot applicable (No entities sted on 49a) [No relationship / Not known
c$ietd 0lgir compan, old Carmilure unde safe Conf
10. Are you a practicing attorney?
Oves {Mo uel Officer/State Attorney
"Yes", check each category of legal representation n which you or the lw fim with which you ae ffilted has earned
| legal fees of more than $10,000 during 2015.
| 0 nemimstrative Dldmiraty 0 Corporate C0 cominal
| [0 Decedent's Estates [7] Environmental O Insurance [O taber
[2 Local Government [1 Real Property. [1] Securities Drax
| [Tort litigation (including OJ utilities Regulation [0 Other category not listed.
free ——————re meee t———aee]
11. Dur 2015, were you a censed professional (other than an attorney) or did You provide consuling services
individually or 25 2 member of @ professional sssocaton for which you charged or were paid over $10,0007
Cves [to
Type of Busineas Nature of Services Rendered l
The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10
Yes no [J Legislator/Judicial Officer - You are not required to complete this question if you are filing because
ame of paren Erm repr r——
‘were you registered as such within the 12 months preceding your filing of this form?
L cm gle
‘Name of Lobbyist 1 Lobbyist's Principal Date of Registration
Frep—— - :
| « receive any "gift{s)" exceeding $200 per quarter from a person or group of persons acting together, and
H + when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and
| [Ives [No 1
»D0 not report gifts given by members of your extended family. oT 1
Date Item Received Name and Address of Donor(s) | Describe Item Received Estimated Market
[5 Se 203 tet tre eros tr ses rts srs, tr re oitas cndiel
ad you
+ those person(s) were outside North Carolina and
+ the scholarship was related to your public poston? A scholarship” i 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.
ves jo Cuca Officer - Yu are not reaured to complet this question you ae fdicl eficer or you are |
Fling a5 a Judicial offices appointee.
> D0 no report gifts that have previously been reprted by you to the Department of the Secretary of State on the
“Expense Report for Exempted Persons.”
> Legislators are not required to report scholarships pad by a nonpartisan legsitive organization of which the legislator
or the General Assembly is @ member or participant or an afflate of hat organizatien. i
Date of Name and Address of Donor(s) Describe Event | Estimated Market
Scholarship Value
|
i. l - — SE
16. Were you appointed or are you being considered for an appGlntment to » covered board by the Governar or another
Canc of State member?
| Council of State members are:
> Governor > Lt Governor » Secretary of State |
» State Autor » State Treasorer > Superintendent of Public Instruction
> Attorney General » Commissioner of Agricuture > Commissioner of Labor
> Commissioner of Insurance
Oves Dro
1 “Yes”, list all contributions you (NOT immediate family members) made during 2015 with a cumulative |
total of more than $1,000 to the Governor ar other Council of State member who appointed you.
» Contributions are cefind in N.C.G.S. 163-278.6(6) and include, but are nat ited t, “any advance, conveyance, |
epost, distiution, ransle of funds, ‘ar, payment, it, pda o subscrpton of money o hing of value
whatsoever.”
Date. Amount Contributed to
No contributions) with cumulative total of mre than $1,000
The SEI and any attachments, excluding the Confidential Form, are public records. Pages of 10
17. Ave you an appointee or prospective appointee to
Sor pepe ——_——
|" Governor, or
b. 2 North Carolina Supreme Court Justice, Court of Appeals, Superior o District
Court Judge; or
a member of any of the following boards:
+ ABC Commission |
+ Coastal Resources Commission |
~ State Board of Education Oves fino |
+ State Board of Elections |
+ Division of Employment Security 1 “No proceed to
+ Environmental Management Commission question 18. \
+ Industrial Commission |
| + Human Resources Commission |
~ Ful Review Commission |
+ Board of Transportation |
+ UNC Board of Governors |
+ Ueites Commission i
+ Wide Resources Commission I |
4. 1f 50, were you appointed or are you being considered for appointment to that [Yes [No 1
| bl positon by a Counc of State mermper? Counc of State members re 156d | 10 who proceed to
| inquestion1s. auestion 18.
iii nis
|e 1 <0, you must indicate whether during 2015 you (no Immediate family
| menibers) engaged in any of the following activities with respect to ar on behalf of
| the candidate or campaigh committe of the Counc of State member who
| appointed you to your pubic position:
| Cives [No
| 1. Collected contributions from multiple contributors, took possession of such
| muRiple contnbutions, and transferred or delvercd those collected
| contributions to the candidate or committee? Contributions are defined in
| auestion 15.
i. Hosted a fundraiser a your residence or place of business? [Cves [Ino
0. Volunteered for campalgn- related activities, which include, but are not Imited
10, phone banks, event assistance, mallngs, canvassing, surveying, or any | [1Yes [INo
other activity that advances the campaign of a candulats? |
16. Have you ever bean convicted of a felony for which you have not received either: () pardon of fnocence; or (1) an
order of expungement regarding that conviction?
ives po
Offense. Date of Conviction County of Conviction | State of Conviction |
19. Ave you aware of any othe information that you befleve may assist the State Ethics Commission in acwising you |
concaming your compliance with the State Government Ethics Act?
[J¥es (No 1 yes, please provide such information below.
|
| |
The SEX and any attachments, excluding the Confidential Form, are public records. Page of 10
| arFramatIon
CT er ———————
Taff that th information provided in this Stateraent of Economic Interest and any atiachments hereto ae rue, complete,
| mses ot ots mt.
also certify tht [have not transfered, and wil nt transfer, any asse,inerest, or property for the purpose of concealing it
from disclosure while refining an cguitebe interes.
T understand that my Statement of Economic Interest and any attachments of supplements thereto (with the exception of the |
Confidential Form regarding Unemancipaed Children) are public record
Tacknowledge that have read and understand N.C.G.S. 1384-26 regarding concealing or fling to disclose material
information and N.C.G.S. 138-27 regarding providing fhe information:
§138A-26. Concealing or filing to disclose material information.
i
A filing person who knowingly conceals or knowingly fis to disclose information that i required 10 be disclosed |
ona satement of economic eres under this Article shal be guilty of Class | misdemeanor and shall be subject
“o disciplinary action wider G.5. 133-45
§ 138A-27. Penalty for false information. b
A ling person who provides fls information on a statement of economic itsest s required unde this Article
Known tha the information i fal s gaily of a Clas H felony and sal be subject to disciplinary action under |
GS. 138A-45. {
01 a8ree N
ion oe lider Vee L Marcel [67 2014
eed Mee Laud E - Bate
aia lolliferd Daugiteides
Printed Name
| submit STGNED, ORIGINAL documents ony. Do not fax or email this form. —
The SET and any attachments, excluding the Confidential Form, are public records. Page 100f 10
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2015 Caldwell Community College & Technical Institute Trustees