Andy K. Griffin

This entire document is a public record. STATE ETHICS COMMISSION 2019 STATEMENT OF ECONOMIC INTEREST NO-CHANGE FORM This entire form must be completed to fulfill your ethics filing obligation. FOR STAFF USE ONLY Date Received: Checked for completion ______ Scanned _______ Date______ Entered in DB ____by______ Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Andy Keith Griffin Reason for Filing (Complete all that apply.) State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State boards on which you are serving or are being considered.) Martin Community College Trustees Judicial Officer (Specify office.) Legislator (Specify House or Senate.) AFFIRMATION The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate to the best of my knowledge and belief. I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding Unemancipated Children public records. I have read and understand the following statutes: N.C.G.S. § 163A-191. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary action under G.S. 163A-415. N.C.G.S. § 163A-192. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415. I affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and belief. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 02/05/2019 Signature Date Andy Keith Griffin Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

ame ELLE Sa IR 73>. NORTH CAROLINA STATE BOARD OF FOR GEMPLSARE UNE. USE ONY 14'g/} ELECTIONS AND ETHICS ENFORCEMENT fou Receiet: ® 2018 STATEMENT OF ECONOMIC INTEREST yo Wis Ao Checked for completion NO CHANGE FORM y Ji scanned Zour THIS ENTIRE FORM MUST BE COMPLETED TO | 10req in oebf/28) FULFILL YOUR ETHICS FILING OBLIGATION = FILER'S NAME (FIRST, MIDDLE, LAST) 5 2 RY, JE E Ay ‘STATE GOVERNMENT JOB (Specify Agency and Position) BOARD/COMMISSION (List the complete name of all State bosds.on which you are serving or are being considered) JUDICIAL OFFICER (Specity Office) LEGISLATOR (Specty House & Senate) rm— _ _ _ oat an Informatio provided i tis Statement of Econom Interest and any tach ments hereto are true, Jompiete, and accurate to the best of my knowledge and belief. aso certy that 1 have not transferred, and wil not transfer, any asst, Interest, or property forthe purpose of Loncesiing i 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 te Confidential Form regarding Unemancipated Children) are public record. © acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing o fling to disclose material formation and N.C.G.5. 138A-27 regarding providing fase information: § 1384-26, Concealing or failing to disclose material information. LL Ating person who knawngy concets or knowingly ats to disclose information tet recur te be icosed A Kom Weare under his Arce shall be gulty of a Class 1 misdemeanor and shall be Shsject to Gscilinary action under G.S. 138A-45. § 1364-27. penalty for false information. A Hing person who provides false information on a statement of economic Interest as required under (is Arte Be ormation false 15 uly of 8 ios H felony and shal be subject to disciplinary action under GS. 1384-45 ! gy J7- 1& Signatyre ate iv Grinted Name L mit SIGNED, ORIGINAL documents only. Do not fax or e-mall this form. This entire document is a public record.

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NORTH CAROLINA STATE ETHICS COMMISSION | ron erwics comassion use ony [= 2017 STATEMENT OF ECONOMIC INTEREST | 0ate Recened & 919-814-3600 Www. ethicscommission.nc.gov oo jp, 10 oT 19 MNe09 THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL Checked a YOUR SEI FILING OBLIGATION shes of Tocomplete 2s Supp. Sent Date o Supp. Receved Date _ jpn. | p FILER'S NAME (FIRST, MIDDLE, LAST) — Prefix i Middle Name Last Name Suffix_| [| [Jen | Goll mre Teme © | 7 0 he rhecu ese N/A 5 Ses "NATURE OR TYPE OF BUSINESS cessws Flt ODA 700g | REASON FOR FILING (COMPLETE ALL THAT APPLY) ‘STATE GOVERNMENT J08 (Specify Agency) 'BOARD/COMMISSION (List complete name of all State boards on which you are serving or are being considered) Part Community College Board JUDICIAL OFFICER (Specify Office) BN LEGISLATOR (Specty House or Senate) A. po other immediate family members reside in your household? es ONo When used throughout this form, the term Immediate family includes your spouse (unless legally separated). it aso Includes members of your extended family (your and your spouse's children, grandchildren, parents, grandparents, and Lilinge, and the spouses of each of those persons) wh reside in your household. Ut the full name of all adults and emancipated minors in your household. A minor is child under 18 years od Himors are emancipated by marmage, enlistment in the US milltary, or court order for emancipation. FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER J08TITLE NATURE OF EMANCIPATED MINORS BUSINESS Lunde Gd whe [6A Buder] Sec The SEI and any attachments, excluding the Confidential Form, are public records. Page 10f10 Soo re irs of 3 emanated mers you household Slow. A mins 1 8 hd under 18 years Note: You must list the fll nam of each minor child on the Confidential Form available at the end of this document. _ NTIALS FOR | RELATIONSHIP EvpLoveR Sos imie STORE OF AEANCIPATED eines ViNoRs PROPERTY INTERESTS 1. As of December 31, 2016, did you, your spouse, or ‘members of your immediate family: rest Hon Caron re estate (nln your residence) with a market volue of ply yd @ve On Sram ARE Cousin oy Gy] Location by County ll rH EY Oullogn sti tags Sd Ctl SU Sanstoe | Sect~ Lanse or rent real estate or persanal property ta.or from the Stale af North Carolin vith a market value of Sib50s or mores ves vo premetp— Same of tosoea | Real Estate, Location | If personal Property, Therion or Cie Coty esere 2. At any time during 2015 or 2016, did you, your spouse, Of ‘members of your immediate family sell to or buy from the ‘State of North Carolina personal property with a ‘market value of $10,000 or more? [Yes @No Torre I TTS NTC Le The SEL and any attachments, excluding the Confidential Form, are public records. Page 20110 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? [Yes @No ea Ted ves find (roan mal funds, reload ese A — emt Gn Ove mo owner of Stogk Option [r— ai Name of Company (D0 not use a ticker symbol C. Interests in 2 non-publicly owned company or business entity (including interests in sole proprietorships, closely held corporations)? Gwner of terest Nore of Company or Business Entity Avdy 4 | Cot Bibeare JW Manson Loc Pine Company or Business Eny | _ Other Companies In which the Primary Company fonpiesndibey ia Security or Equity Inarests pT— J sss eT a oT RE SR TR Cr SC) over Tel Bs | To Co LY sine he ae ove svt | ems Be ere of Company or Business ERY pn o Swine Aci wit he Ste nor ve oe 4. As of December 31. 2016, were you, your spouse, of ‘members of your immediate family the beneficiaries of a vested Ae DL Gr Yo ote by You | Do not list assets held in blind trusts. Gee 2017 SEI Helofu Tips for the definition of “Vested Trust” and “Blind Trust.” [Yes WNo errors | pesciptonarie vst | Vor Ratoni tote rst 5. As of December 31, 2016, did you, your spouse, or ‘members of your immediate family have liabilities of $10,000 or (more, excluding the mortgage on your pnmary personal residence? Examples include credit card debts, auto loans, student. ore cig he me CV EY [ves No or ven Svovee mada Fry | Tye of Crr (Commercial Back, Cred Union, hee) Commas 6. List each source of income (not specific amounts) of more than $5,000 received by you, your ‘spouse, or members of your immediate family during 2016. Include salary, wages, state/local goverment retirement, professional fees, yor edie ony dito 1016 rete S97, nae, SLE Caled ob mid on ou oo nt chad Income recived from th folowing sources: capt gains return goverment reiamant * mar rsement ete sasuiy eae! $501 rep— mer Ep r— te tndusty Ct rae ne ov BE OIE J 7 J] AL J Goblas |Gotln Bed | ad Pacession | Sale rudlerb GH | PET S/n A / F. / [Ad kG : Farn.e sles oles me anc any attachments, excluding te Cofidntia For are publ eco. rage oro PROFESSIONAL AND CIVIC RELATIONSHIPS 7(2). During 2016, were you, your spouse or 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 the State of North Carolina primarily for religious, charitable, scientific, literary, public health and safety, or educational purposes? [ves #No- If "No," proceed to question &. > Do not lst State boards or entities, or entities created by a political subdivision of the State. » Do not list organizations of which you are a mera member. Name of Person His/Her Position Name of Nonprofit Nature of Business or Corporation or Organization | 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, please provide a brief description of the nature of that business, if known or with which due diligence could reasonably be known. Name of Nonprofit Corporation or Organization | Describe State Business or State Funding J None or Not Known 6. During 2016, were you, your Spouse, or 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 junsdiction? [Ives @No [JLegisiator/udical 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 2n appointee to those offices. Do not list organizations of which you are only a member (not serving in a leadership role). Name of Society, Organization Leadership Position or Advocacy Group (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 5(2). List the name of each company or business with which you were associated where you or a member of your (mmediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2016. Name of Person Relationship to Filer ‘Name of Company Role of Person No Business Associations. J) 7) FZ J A winter cl. 12 Goll Porheoe Se (5) 1 you know that any company or business ently sted in S(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, 2016, provide 3 brief description of that business activity. ‘Name of Company or Business Entity Description of Business Activity with the State 10. Are you a practicing attorney? [OYes @No [Judicial Officer/State Attorney 16 "Yes, check each category of legal representation in which you or the law firm with which you are affliated has earned legal fees of mare than $10,000 duriod 2016. J Administrative 0) Admiralty Ocorporate Criminal [Decedent's Estates 0 Environmental Otesurance Otabor Local Government [Real Property. [Secures OTex [ort litigation (including [utiles Regulation [Other category not listed. negligence) 11, During 2016, were you 3 licensed professional (other than an attomey) or did you provide consulting services Individually or 3s a member of a professional association for which you charged or were paid over $10,000 Oves gho — The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. Are you or your employer, your spouse or members of your immediate family, or their employer curently: | + Licensed by the State board or employing entity with which you are or wil be associated or Regulated by the State board or employing entity with which you are or wil be associated oF ave 2 business relationshio with the State board or employing entity with which you are or will be associated? [ives Wo [)Legisiator/Jucicil Officer - You are ot required to complet this question il you are fing because a ar Taasiator of 5 sodical office (udical office” is defined in the SEF Helpful Ts) or you are ing 35 an appointee to those ofces. Name of person Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) —_— terme eet 13. Are you, your spouse or 2 member of your Immediate family currently registered as lobbyist or lobbyist principal, or here you realtered as such within the 12 months oreceding vou fing of tis form? Oves gro | Name of Lobbyist Lobbyist's Principal Date of Registration Registration Expiration loMerpiscosures 14. During any calendar quarter in 2016 (but ony the time period afer you were appointed, employed or fled or were nominated as » candidate), dd you receive any gis)" exceeding $200 per quarter rom a person or group of persons acing together, And when both you and those persan(s) were outside North Carolina a the time you accepted the ifs), and the gi(s) were given under Grcumstances that would lead a reasonable person to Conclude that they were given for lobbying? Ove BN +o not report Gs gen by members of your extended arly. ~ — +00 not report gifts that have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received [emer | I EE I The SEX and any attachments, excluding the Confidential Form, are public records. Page7of10 ° 15. During 2016 (but only the Ume period ater you were appointed, employes, o filed or were nominated 35 3 candidate) did vou + accept a “scholarship* exceeding $200 from a person or group of persons acting together and + those person(s) were outside North Carolina and + the scholarship wes related to your public position? A “scholarship” is a grant-in-aid, elther direct or indirect, to attend a conference, meeting, or similar event, Including tuition, travel, lodging, meals, and other similar expenses. Yes gio [Julia Officer - You are not required to complete this question f you are a judicial ofcer o you are filing as a judicial officer appointee > Do not report gifts that have previously been reported by 700 to the Department of the Secretary of State 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 or participant or an affilate of that organization. Date of ‘Name and Address of Donor(s) Scholarship. [[16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or another Counc of State member? Council of State members are: > Govemor > Lt. Governor > Secretary of State » State Auditor > State Treasurer > Superintendent of Public Instruction > Atorney General > Commissioner of Agriculture» Commissioner of Labor > Commissioner o Insurance Ove @no 1 Yes", lst all contributions you (NOT immediate family members) made during 2016 with a cumulative | total of mare than $1,000 to the Governor or other Council of State member who appointed you. > Contributions are defined in N.C... 163-278.6(6) and include, but are not limited to, “any advance, conveyance, deposi, distribution, transfer of funds, loan, payment, gf, piedge or subserption of money or anuihind of valle. ‘whatsoéver,” i Date Amount Contributed to | # No contribution(s) with a cumulative total of more than $1,000 The SEI and any attachments, excluding the Confidential Form, are public records. Page of 10 ( 17. Are you an appointee or prospecive appoiiee to - 3. the head of a principal sate department (60. cabinet secretary) appointed by the Governor; or 5. 3 North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court Judge: or <a member of any of the following boards: + ABC Commission Coastal Resources Commission ~ * State Bord of Education Oves no * State Board of Elections ~ ivisan of Employment Security 1 “No proceed to © Environments! Management Commission Question 18. © industrial Commission © Human Resources Commission ~ Rules Review Commission * Board of Transportation © UNC Board of Governors © tities Commission * Widife Resources Commission & 50, were you appointed or are you being considered for appointment to that Ives [INo or Counc of Scie member? Counc of State members are ISted | 3p “No,” proceed to in question 16. eis. = so, you must indicate whether during 2016 you (not immediate family eoigere) ngage m any of the following activities with respect to or on behalf of he conirdate o campaign committee of the Counc of State member who Sbpomed you to your pubic postion: [les [No \. Collected contributions from multiple contributors, took possession of such ie contributions, and transfered or delivered those collected Cotritions o the candidate or committee? Contributions are defined In Question 16. Hosted a fundraiser at your residence o place of business? Oves_ OMe volunteered for campaign relied actwies, which include, but are na imied | a ano. evant asastance, mailings, canvassing, Surveying, or any | C1¥es CINo her activity that advances the campaign of a candidate? 15. Hove you ever been convicted of a felony for which you have not received either: () a pardon of innocence; or (1) an andar of expangement regarding that conviction? Ove @to [ee] Date of Conviction | _ County of Conviction State of Conviction Tove you aware of any omer formation thal you belleve may assist the State Ethics Commission In advising you Cancaring your compliance with the Sate Government Eth Ac? [Yes @No If yes, please provide such information below. The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 1 understand that my Statement of Economic Interest and any attachments ‘or supplements thereto (with the exception of the | to disciplinary action under G.S. 138A-45, | § 1384-27. Penalty for false information. Hn A [0-17-17 4 ;