Andrew Mason Berry

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 Andrew Mason Berry Current Employer Job Title Self Commercial Fisherman Nature or Type of Business Commercial Fisherman 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.) Funding Committee for the NC Commercial Fishing Resource Fund 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 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 PB Child 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 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) 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 Andrew Mason Berry (Self) Commercial Fishing Commercial Fishing Other type of income 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. Name of Person Name of Society, Organization, or Advocacy Group Leadership Position (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 9(a). List the name of each business with which you were associated where you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2018. Name of Person Relationship to Filer Name of Company Role of Person No Business Associations 9(b). If you know that any entity listed in 9(a) above had any material business dealings or business contracts with the State of North Carolina or was regulated by the State as of December 31, 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 06/21/2019 Signature Date Andrew Mason Berry Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

NORTH CAROLINA STATE ETHICS COMMISSION 2018 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM FILER'S NAME (FIRST, MIDDLE, LAST) Prefix First Name Middle Name Last Name Suffix Mr. Andrew Mason Berry REASON FOR FILING (SELECT ALL THAT APPLY) STATE GOVERNMENT JOB (Specify the agency for which you work or are being considered) BOARD/COMMISSION (List complete name of all State boards on which you are serving or are being considered) Funding Committee for the NC Commercial Fishing Resource Fund; JUDICIAL OFFICER (Specify the office you hold) LEGISLATOR (Specify House or Senate) The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 2 AFFIRMATION I affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. I also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Children) are public record. I acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest under this Article shall be guilty of a Class 1 misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest as required under this Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I hereby affirm that I have reviewed my most recently filed 2017 Statement of Economic Interest and that as of December 31, 2017, my responses continue to be true, correct, and complete to the best of my knowledge and belief. I Agree. It is my intention that this check box constitutes my electronic signature. By checking this box I certify that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. Filed Electronically 4/12/2018 Signature Date Andrew Mason Berry Printed Name The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 2

NORTH ATE ETH ol IORTH CAROLINA STATE ETHICS COMMISSION co cries commission ust ov FES Dare Reco 1 47° 2017 STATEMENT OF ECONOMIC INTEREST N " & " APR 2 12017 RECEIVED APR Z NO CHANGE FORM Checked fo completion QC. THIS ENTIRE FORM MUST BE COMPLETED TO | <cinnes one FULFILL YOUR ETHICS FILING OBLIGATION I Entered in D0] iby 24t I | [Faews mame (FIRST, MIDDLE, LAST) - FILER'S pang (FIRST! rrr————————— [bratix | FustName | Migdie Name Last Name Suffix Andie Flaccin Beily = REASON FOR FILING (COMPLETE ALL THAT APPLY) oo i} _ STATE GOVERRMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (List the complete: name of all State [a ~ boars an which you are serving or are being considered ¢ . , n ~ Commericial Lohing fond Comin fe JUDICIAL OFFICER (Specty Office) | cecistaroR (spect House or Senate) - | | I — RPFRATION = Ta16r that the information provided in this Statement of Economic Interest and any attachments hereto are tre, | Complete, ond accurate ta the best of my knowledge and beef | | 1 also certify that 1 have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing | from disclosure whia retaining an cauiable (terest 1 understand that my Statement of Economic Interest and any attachments or Supplements thereto (wih the exception of the Canfidential Form regarding Unemancipated Children) are public record | 1 acknowledge that 1 have read and understand H.C.G.5. 1588-26 regarding concealing o fang 1o disclose material information and N.C.G.5. 138A-27 regarding providing flse information | § 1384-26. Concealing or failing to disclose material Information 2 Statement of econamic terest under this Article shal be Gully of a Class 1 misdemeanor and shall be Subject to disciplinary action under .5. 1384-45. | § 1384-27. Penalty for false information. Knowing that the Information 5 315 15 Guity of 3 Class H felony and shall be subject to disciplinary action under | Gs. 136nas I hereby affirm that T have reviewed my most recently filed 2016 Statement of Economic Interest and that as | of Docomber 31, 2016, my respanses continue to be true, correct, and complete to the best of my knowledge | and belief. | 1 Agree Clelun /H iden . -7/2:47 Signature > Bate | Hiclicw. Mase 1heicy | Printed ame Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form. I | This entire document is a public record.

NORTH CAROLINA STATE ETHICS COMMISSION 2016 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM FILER'S NAME (FIRST, MIDDLE, LAST) Prefix First Name Middle Name Last Name Suffix Mr. Andrew M Berry REASON FOR FILING (SELECT ALL THAT APPLY) STATE GOVERNMENT JOB (Please specify the agency for which you work or are being considered) BOARD/COMMISSION (Please list complete name of all State boards on which you are serving or are being considered) Funding Committee for the NC Commercial Fishing Resource Fund; JUDICIAL OFFICER (Please specify the office you hold) LEGISLATOR (Please specify House or Senate) The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 2 AFFIRMATION I affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. I also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Children) are public record. I acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest under this Article shall be guilty of a Class 1 misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest as required under this Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I hereby affirm that I have reviewed my most recently filed 2015 Statement of Economic Interest and that as of December 31, 2015, my responses continue to be true, correct, and complete to the best of my knowledge and belief. I Agree. It is my intention that this check box constitutes my electronic signature. By checking this box I certify that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. Filed Electronically 4/13/2016 Signature Date Andrew M Berry Printed Name The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 2

72%: NORTH CAROLINA STATE ETHICS COMMISSION | eh! g/l 2015 STATEMENT OF ECONOMIC INTEREST | 0% €Mics commission se ony 919-715-2071 wwetiCscom Missa negoY yc ur 1 1: 26 FILER'S NAME (FIRST, MIDDLE, LAST) [_orsthame T wiadeName | cestheme | sum | {Andrews | Maso Bere | [comer emnoen ~~ hoenme 7 | [ Self-employed |Zommercia Js her ma NATURE OR TYPE OF BUSINESS } CJSTATE GOVERNMENT 08 (Please spect the agency for | (BOARD COMMISSION (Plas lis complete name of al ‘which you work or ae being Considered) State boards on which you are serving or ae bing considered Working with Observer rogrom QEPEHSISRIRCIRSF JUDICIAL OFFICER (Please specty the office you hold) _| [J LEGISLATOR (Please specty House or Senate) D0 sehr immediate fomly members resid in your household? Yes [No When used throughout this form, th term Immediate family includes vour spouse (unless legally separated). It also includes members of your extended family (your and your 3pouse’s children, orandehien. parents, orondparents, and Siblings, and the spouses of cach of those persons) Wh reside in your household, ONLY LIST THE INITIALS OF UNEMANCIPATED CHILDREN. However, you MUST submit the children's full names on the Confidential Form avaiable at the end of this document. Minors are emancipated by marriage, enlistment in the US itary, or court action for emancipation. EMANCIPATED MINORS | LEH gpl | 7 The SEX and any attachments, excluding the Confidential Form, are public records. Page 10f 10 ITAL For NATURE oF UNEWANCIPATED ‘BusInESs nLonen PROPERTY INTERESTS 1. As of December 31, 2014, did you, your spouse, or members of your immediate family: A. Hove an amnersip interest in North Carolin rea estate (inciucing you residence) wit a market value of $10,000 more? [owner of eal estate || o Ownership interest Location by County B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of $10,000 or are? Oves oe I Real Estate Location | 1 Personal Property, by City & County Describe 2. At any time during 2013 or 2014, did you, your spouse, or members of your immediate family sell to or buy from the Ti personal property witha marke value of $10,000 o more? Oves oe Nome of Purchaser Name of Seller T— Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20110 FINANCIAL INTERESTS 3. As of December 31, 2014, did you, your spouse, or members of your immediate family own any of the following financial interests valued at $10,000 or mare? A. Stas in 3 publicly owned company? Ove: fe »D0 not lst ownership Interests in 3 widely held investment fund (including mutual funds, regulated investment Comparits, or pension o defer compensation pane i: (1) the fund 18 pub ded or 1 assets are widely Givers: ond i) noier you nor an Immediate family member ar abe to contr the assets held in the mutual fund, Investment Company o person of Gefered compensaton pan. Owner of Interest Full Name of Company (Ba not use a ticker symbol) 8. Stock Options ip company or business? Ove ‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol) C. Interests in a non-publicly owned company or business entity (including interests in sole proprietorships, Farina, HES poinersnrs, Jom veneres, ited 1sbity companies, ited abbey painershss, and Gorey nls ccgpdtation)? Oves No - If "No", proceed to question 4. [CC ownerotmmees | Name of Company or Business Entity The SEL and any attachments, excluding the Confidential Form, are public records. Page 30 10 (1). For cach non-publicy owned company o busines entity (ie “primary company’ ented i question 3.C aD, lease ls ihe names of any oper Companies or BUSINESS €nCHES i Whe th rumor compan ows Securins or equty interests valued t over $10,000, known: Non-publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the primary Company) Gna Security or Equity Interasts C(@). 1 you know that any company or business enc sted In 3.C o 3.C(1) above hos any materia business dealings or business contracts with he State of North Carling or regulated by th State, provide » ref description of hat business actiy: Description of Business Activity with the state Cotons or Not known } "4 7s of December 31. 2014, were you, your spouse, or members of your immediate family the beneficiaries of a vested rust wih 3 va of $10,000 1 hare hat was Created, XaDIEnEd, of COnTSNES 8 yous Do not list assets held in blind trusts. See 2015 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” ove fe por Tors 5. A of December 31. 2014, 4d 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, Shudent loans, persona ans and ira-fam Get. DYes [No Nome of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Viember) Lndidusy, ate) Andres Bere Lommerctal Thank Andrews Bere. nd/vidua Andrew Bere Tad viva The SEX and any attachments, excluding the Confidential Form, are public records. Page of 10 6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of | your immediate Tomi during 2014. Include Saar, WSges, Seo sovernmens elven prosssoral Foca honoraria, itaret, didends, Enka Income, Dunes income, 3nd other (ype of COME required 1b reported on your Sto and eders to rere. Do ot include income received from the folowing sources: » Capital gains > Federal government retirement » Miltary retirement > Social security income/SSDI Name of Source Type of Type of Tncame SU | SlRimess/maustry [JT had no reportable income over $5,000 in 2014. Oneal’s Sea Harvest Padeews Be ane Cedar Reclortt Lommeccial Lochs | | prOFESSTONAL AND CIVIC RELATIONSHIPS 700) During 2018, were vou, your spouse or members of your immediate family a dredor, offer, governing bord ember, empioyes, independent contactor, or regslred bey of » SORDIO corporation or or0onauon epg I the Sate of North Caroling primal for rilous, CRantabi, scenic, eran; PUbIE heath and Safer. or education] Purposes? Oves lo - If "No", proceed to question 8. > Do not list State boards or entities, or entities created by a political subdivision of the State. > Do not lst rganizetions of which you are a mere member is Hr position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization I EE 7000. 1 he nonproft corporations o organizations std hove oo Susess wis the State of Noth Caroline o receive State funds, please provids a Del descnption of the nature of ho business, f Known o with whch de dgence coud easonably be known. Name of Nonprofit Corporation or Organization The SEI and any attachments, excluding the Confidential Form, are public records. Page s of 10 DT 2013, We vou Vou Spee or mer oF our TSA ay recor Gee 7 Going Sod mbar any act. oSaNion, or K0v0Ea0 rou Wht on eres, EE tS pe or Pod Tov ora ve Ge Oem oie roc required to complete this question if you are fing because Vou a EOD of nl eo rH open ou re tr 00 not It arganzations of which you ar only a member (ot sing in 3 lnders rl). Name of Society, organization Leadership postion or avec Goong recto, Ofte, Board ember) S00) te name of cach company or business WN Wh vou were sssoomes wher you 2 3 memes oT You nit Ari was a Slopes, econ, ews Donn Brooch a Tense are oof cect Oto [Mame of reson | etatonshp to ier | Name of company | Role of person ho business socio S001 you kv akan company a Boies sn aed 13a) obove had ary areal Bones ais a Sours a Sr orca ess 48) aha bad ars arr ines desig or Coston of tt ies ri Name of Company or Business Entity Description of Business Activity with he Stats Not applicable (No entities listed on #9a) [J No relationship / Not known Frayer: mpr— ves fhe Chui offerte tomer Ve, chck ech category of eg representation in which yo or the ow i with which you ae fad as corned legal fees of more than $10,000 during 2014. Dramas peyvm—— comme ama Dloecedents Estes JES ET Outer [0 Local Government (OJ Real Property O) securities. OTax Dor tgatn (ncudng ~~ Clute Regulation thr category nt He, pricey The SEE and any attachments, excluding the Confidentit Form, ae public records. Pose sot 10 1 During 201s, werpvau Wosraed profesional (over an an Stormer) or 90 you ponds cred seen Indl o 35 ePnbe of 3 Proteome svso0aton for WE You charged or were pos or 10 12. re you or your erlover, your spouse of members of your immedita family, o thr slog cent: « Licensed by th State board o empleying nt ith which you ae or wil be sesocited or Recut the State board or employing ent with which you are o will assacited or © ie et li ie Ste 5 oy i 1 5 Qves io [] Legislator/Judicial Officer - You are not required to complete this question if you are filing because ‘you are a legislator or a judicial officer (“judicial officer” is defined in the SEI Helpful Tips) or you are Deer pn te acc Nara of Person Name of Employer Type of Relationship i appicable Qcansing, Regulatory, Business) FT pp egy AE epg wrmm pm — ‘were you registereg as such within the 12 months preceding your filing of this form? Ove ho Name of Lobbyist [reSr— Date or Registration Repinaton | Eepiadion |oTHer prscLosures 4. arg ar center suarer 2554 (ou ony the ve paid ar you were ppovees, spores or ed or wore el ors cree a vou + receive any “gift(s)” exceeding $200 per quarter from a person or group of persons acting together, and + when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and BE AA SAARI re lobbying? OYes No »Do not report gifts given by members of your extended family. D0 rot report ifs tha have prevauly been epores by vou tthe Department of the Secretary of Stte an the pens Rapon fr Examptas bersons” [Date Item Received | Name and Adaress of Donors) | Describe ttem Received | Estimated Harket vate | | | | SE RS The SEX and any attachments, excluding the Canfidental Form, are public records. Pager 10 15. During 2014 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) ad vou + accept a “scholarship” exceeding $200 from person or 9roup of persons acting together and + those person(s) were outside North Carolina and | the scholashibvas related to your public poston? A “scholarship” is a grant-in-aid to attend a conference, esting, or similar event. Caves fo Cusco Offer - You are not required to complet tis question you ae a Judicial officer o you are ing 333 Juda officer appoimes. > Do not report ifs that have previously ben reported by you to the Department ofthe Secretary of State on the Expense Raper for Exempted Persons.” > Legislators are not required to report scholarships paid by a nonpartisan egilative organization of which the legisator or the General Assembly 1s member or patcsant o an flats of that organization. Date of Name and Address of Donor(s) Describe Event Eetimated Market | scholarship. | Vaiwe | 16. Were you appointed or ar you being considered for an appOEnt ta 8 covered board by the Governor or another Counc of Sate members Council of State members are: > Governor > ut. Governor » Secretary of state » state Auditor > state Treasurer > Superintendent of Public Instruction > Atomey Genera > Commissioner of Agriculture Commissioner of Labor > vel of Insurance Oves who If “Yes”, list all contributions you (NOT immediate family members) made during 2014 with a cumulative total of more than $1,000 t0 the Governor or other Counc of State member who appainted you. | » Contributions are defined in NCGS. 163-278.6(6) and include, but are nt ite to, "any advance, conveyance, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” 0 Ko conrbutonts) with = cumulative total of more than $1,000 The SEI and any attichments, excluding the Confidential Form, are public records. Pages of 10 I ee you ar ap AE SE PT Pp — pp ——r—Th pistol 5. 2 North Carlin Supreme Court ute, Cort of Appeas, Supror or Distt Gout ts . 3 member of any of th follwing bores h8C Commisan Const Resoteas Commission + State Board of Education Des No ~ Stoe sou of chon ~ Ovi of Employment Sau nor, proceed to JA A— esion 18. ~ Indu Comlsoon tan mares Comision ~ Rute Review Commissin ~ ord af Tarsponatin © DNC bots of overs | ~ Utes orion * tie resoweas Commission d. If so, were you appointed or are you being considered for appointment to that public |] Yes [JNo iy Sao Sr meer Cun of Sr meme a ean | ty proceed 2 - question 18. e. If 50, you must indicate whether during 2014 you (not immediate family members) ronan oo ow Seta wh ei on hal of aioe ar capo comme ofthe Counc FS amber whe oopoted sips pe hos DOYes [No I Collie contributions from lie controtors, ak passion of such nls ombotons i Hanes deer a coe cvmptons tne carbons o ermtens Contains or deed esto 16, Hosted a fundraiser at your reser o place of bins? [Ove ome | Th Voliered for compl relted aces, which nce, bt re Tor ed phone banks, event assistance, mailings, canvassing, surveying, or any other [Yes [INo Seovas tok Sivan he coo of coon 18. Have you ever been convicted of a felony for which you have not received either: (1) a pardon of innocence; or (ii) an fritters ove othe [ omems | osteol conviction | County of Conviction | state of Comicon I Are you ware of ay otf formation hat 7 Ble ay Jt th Sa Ev Commisn navi vu canes iin So veto Sv Dives ff if yes, peas provide such informacion below: The SEX and any aiPichments, excluding the Confidential Form, are public records. Page sot 10 AFFIRMATION A FO SY nd scrote he bot of my knowiedg and bt Valo ceity tha ave not rand, and illo nsf, asc, erst or property for the purse of concealing 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. Yeetmtdge tt os rt an erst N.CA3.5. 1585-Bvoguefing concsling oe Fling dons mars information and N.C.0.5 1384.3 regarding providing se formato § 138-26. Conceling or ling 10 disclose materi information A ig person who knowingly conceals o knowingly fils to dilose information thats eid to be disclose ona Came of eonomi ert ss is Afi hb uty 673 Cl | mdenane nd este | nena action under G5, 159A45. § 138-27. Penalty for ls normation. A ling person wh provides ls formation n samen of conomic rest as rived under is Avice Knouiag ha he formations lo Gly of Caos lon and sll b sens vo tpt so and G5. Ta Hoare Andrew Mason Berry Printed Name Cos ogo fog — Submit SIGNED, ORIGINAL documents oaly. | Do wo os or emai this form. |