Angela T. Goodrich
Hearing Aid Dealers and Fitters Board
Filings
2019 Hearing Aid Dealers and Fitters Board
Document text
ZEN UseAPRY
) STATE ETHICS COMMISSION os reer RHR T 8 7013
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27: ETHI HSSION
) Ae #/;/ 2019 STATEMENT OF ECONOMIC INTEREST SHIRES COM
= NO-CHANGE FORM checked for completion FS
This entire form must be completed to fulfill your Scanned SIS ome [22/14
ethics filing obligation. En
Files Nome (First, Middle, Last) i . = 1
Prefix | First Name Middle Name Last Name Suffix
rstName [idle Na — testteme
Ar [Angel [Toney Cede |
Reason for ing (Complete al het apply. : ]
‘State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State |
| Boards on stich you are serving o ae send conatres
Heasing Ad Deals and Fides Bod |
Suda Officer (Spec office) es Lesisator (Spey House or Senate.)
The formation provided n thi Statement of Economic intrest and any attachments are true, complete, and accurate to
the best of my Knowiadge and barat |
have not transferred, and wil nt transfer, any asse, interes, or property for the purpose of concealing i from disclosure
while einng an equa meres.
|
1 nderstand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
| Unemanciates Chidren pit records:
NCGS. § 1634-191. Concealing or falling to discose mater information
| 21m prtoteoty one rsoncor i astm orton ori ctor |
|| 2 statement of cconomic interest shall be quit of a Gass 1 misdemeanor nd. soa gon sosedon |
Under GS. 1638415. |
| NCGS. § 1634-192 Panay for ole formoten. |
fling person who provides false Information on a statement of economic terest... knowing tat the information
is als 15 guity of a Clas H felony 3nd shal be Subject to dcinary acon soir G.6. omnes
| December 31, 2018, my responses continue to be tre, correct, and complet to te best of my pomiecne and
beter |
affirm under penalty of perjury that the foregoing is true and correct. |
( Lass) etn Yer -/G
Sompture fa a Bate |
gels T Cue ited Mime
‘Submit signed, original documents only. Do not fax or e-mail this form. |
This entire document is a public record.
2018 Hearing Aid Dealers and Fitters Board
Document text
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
Angela Toney Goodrich
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)
Hearing Aid Dealers and Fitters Board;
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 5/24/2018
Signature Date
Angela Toney Goodrich
Printed Name
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2
2017 Hearing Aid Dealers and Fitters Board
Document text
NORTH CAROLINA STATE ETHICS COMMISSION
2017 STATEMENT OF ECONOMIC INTEREST
NO CHANGE FORM
FILER'S NAME (FIRST, MIDDLE, LAST)
Prefix First Name Middle Name Last Name Suffix
Angela Toney Goodrich
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)
Hearing Aid Dealers and Fitters Board;
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 2016 Statement of Economic Interest and that as of December 31,
2016, 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 4/13/2017
Signature Date
Angela Toney Goodrich
Printed Name
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2
2016 Hearing Aid Dealers and Fitters Board
Document text
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
Angela Toney Goodrich
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)
Hearing Aid Dealers and Fitters Board;
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 2/23/2016
Signature Date
Angela Toney Goodrich
Printed Name
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2
2015 Hearing Aid Dealers and Fitters Board
Document text
NORTH CAROLINA STATE ETHICS COMMISSION
2015 STATEMENT OF ECONOMIC INTEREST
No-Change Form
FILER'S NAME (FIRST, MIDDLE, LAST)
First Name Middle Name Last Name Suffix
Angela Toney Goodrich
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)
Hearing Aid Dealers and Fitters Board;
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 2014 Statement of Economic Interest and that as of December 31,
2014, 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.
Angela Toney Goodrich
Printed Name
Filed Electronically 2/19/2015
Signature Date
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2