Ann Floyd Huggins

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 STATE ETHICS COMMISSION 2025 STATEMENT OF ECONOMIC INTEREST ELECTRONIC FILING This entire form must be completed to fulfill your ethics filing obligation. Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Commi ssioner Ann Floyd Huggins Current Employer Job Title Retired Retired Nature or Type of Business Retired Reason For Filing (Complete all that apply.) Are you a CANDIDATE for elected office? ☐ Yes ☒ No If yes, for what position are you seeking election? (Specify name of office seeking in box below.) Do you currently hold this position? ☐ Yes ☐ No State Government Job or Post-Service Filer (Specify agency and position.) Board/Commission (List complete names of all State boards on which you are serving or are being considered.) Mid-East RPO (TAC) Judicial Officer, Post-Service Filer, or Judicial Officer Appointee (Specify office.) Legislator, Post-Service Filer, or Appointee to Legislative Office (Specify House or Senate.) A. Do any immediate family members reside in your household? ☐ Yes ☒ No On this form, ”immediate family” includes your spouse (unless legally separated) and unemancipated children (minors under 18 years of age). 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 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, 2024, 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 Ann Floyd Huggins (Self) 100.00% Greenville Pitt Ann Floyd Huggins (Self) 100.00% Greenville Pitt 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 2023 or 2024, did you or any members of your immediate family sell or buy personal property worth $10,000 or more to or from the State of North Carolina? ☐ 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, 2024, 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 ► Include stocks held individually of in a portfolio managed by a financial services company 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, 2024, 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 2025 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” https://ethics.nc.gov/seis ☐ 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, 2024, 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. Do not disclose the amount of the debt. ☒ Yes ☐ No Name of Debtor Type of Creditor (commercial Bank, credit union, individual, etc.) Ann Floyd Huggins (Self) Credit Union Ann Floyd Huggins (Self) Credit card 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 2024. 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. You must disclose your receipt of salary or wages from any governmental or private entity, including those already listed in response to other SEI questions. Do not include income received from the following sources: ► Capital gains ► Federal government retirement ► Military retirement ► Social security retirement, survivors, or disability benefits Recipient of Income Name of Person or Entity from Which Income Was Received Type of Business/Industry Type of Income Ann Floyd Huggins (Self) Pitt County Government Board of Commissioner Salary Salary The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Professional and Civic Relationships 7(a). During 2024, 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, or entities created by local governments. ► 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 Ann Floyd Huggins (Self) Board Member Pitt County ABC Board Pitt County ABC Board 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 Pitt County ABC Board Sales 8. During 2024, 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 solely because you are a legislator or judicial officer or as a candidate or appointee to 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 for profit business with which you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2024. 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, 2024, 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/In House/Employee 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 2024. ☐ 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 2024, 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 solely because you are a legislator or judicial officer or as a candidate or appointee to 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 2024, after you were appointed, employed, or 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? To answer Yes, all three conditions must apply ☐ 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 2024, after you were appointed, employed, or 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? To answer Yes, both conditions must apply 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 filing solely because you are a legislator or judicial officer or as a candidate or appointee to those offices. ► 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 2024 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. 163-278.6(6) 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  Utilities Commission  Wildlife Resources Commission ☐ Yes ☒ No If “No,” proceed to question 18. d. If yes, 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 yes, you must indicate whether during 2024 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. § 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 . . . shall be guilty of a Class 1 misdemeanor and subject to disciplinary action under G.S. 138A-45. N.C.G.S. § 138A-27. 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. 138A-45. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 02/06/2025 Signature Date Ann Floyd Huggins Printed Name

Pr. mere RECEIVED GET a STATE ETHICS COMMISSION APR 15 2018 Nl 2019 STATEMENT OF ECONOMIC STATE ETHICS COMMISSION 2 INTEREST EN Cracked fog campleton This entire form must be completed to fulfill Forres Aes your ethics filing obligation. Incomplete Qs ___ Supp. sem ante w_ Supp. races ome entre in cates on Fler’ Nome (First, Middle, Lost) FE = ER YY Job Tite LP Covafy 1Couafy Commisiionc= Gavernmen Reason For Filing (Complete all that apply.) on which you ar serving o are being considered 1 lati Luther fin Sri Commission Legiistor (Specity House or Senate.) ] | A. Do other immediate family members reside in your household? re Re On is ok, “imeditefomiy includes your spouse (unless legal separated). It so incudes members of your | extended family (your and your spouse's children, grandchildren, parents, grandparents, and Sbings, and the spouses of each of those persons) who reside In your household. | Lst the ull name o all adults and emancipated minors in your household. Minors are children under 16. They are emancipated by marriage, enstment inthe US miltary, or court order for emancipation Et | i |r | seen ‘Emancipated Minors The SEX and any attachments, excluding the Confidential Form, are pubic records. Page 10f10 ete at El a a ‘Unemancipated Property Interests fo on | Owner of Rei Estate | % Ownership Interest | Location by City | Location by County _| PTE SR PA. al PPV . y OYes RNo Fn by City & County OvYes XNo [ vameotruamr | Wemeotsaiwr | Twmatrropery Financial Interests | Ty a ea Ten, I | owner osname Ere — TTB Ars SL A Ty {0 None or not known I —— panzer re or Sr Ss Spe oescripion of Business Act with we sae FT ———— ae TL SAL ees Do not list assets held in blind trusts. ‘See 2019 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” ves ae | ame na earns oases | oescrtpion ous | our netritpo te vr_| seer 3,208, 4 ory meer fe et RTS personal foans and intra-family debt. | ve Ov | SE— Sn ge individual, etc.) ES re overs hte tnt oe SEX am sy nchmert, xchange Content Form ae publi esr. —— Des [No If "No," proceed to question 8. Hera EE EE OYes [No ()Legisator/ucical Office - You are not required to comple tis question f you are fing because TTT | Sametre | ramos | ametconsany | _soatrenen | i ts ie I EE EE EE I I EE EE I I I EE I EE EE EE I EN 1 EE Oves [No [udicl Offcer/State Atomey A Srey Dire 1 I oS a an cat, lin he Gon fore, put et eres + regulated by the State board or agency with which you are or will be associated or | Er —— Er — Compre: Forres — rn RA overnbent| 7 | 7 CU] other Disclosures Oves ®iNo ‘Date Item Received | Name and Address of Donor(s) | Describe Item Received | mmm] we eat ST —— Ere rn, sh as 7 oc 0 2 athe CL — Oves Eo oR — an ah conto sou men 208 ih 3 com or 1 no 01 I TR I Ee I —— 17. Ave you an appoint or prospective appointee a5: © een of rnc st pT (5, ABT sea) pond 0 5. North Carolina Supreme Court Justice, Court of Appeal, Superior or District Court Judge; or a member of any of th following boards: + ABC commission © Coastal Resources Commission + State Board of Education OvYes RNo © State Board of Elections * Divison of Employment Security I Nos proceed to © Envronmental Management Commission Question 18. © Industrial Commission © Human Resources Commission * Rules Review Commission * Board of Transportation © UNC Board of Governors © lies Commission Wide Resources Commission 1 0, were you appointed or are you being considered for sppalnment to that | JYes JN postion by Counc of State member? aT prviol 4h Question 18. a Wo, you must Inicate whether during 2016 you engaged In any of th folowing cine wih respec t or on behalf of th candidate of campaign commitee of The Council of State member who appoiNed You: 1. Collected contributions rom multiple contributors, took possession of such ile contmutions, and transfered or elered those collected antibutions to the candidate or commites? Hosted » fundraiser at your residence or place of business” Oves ONo i. Volunteered for campaign-reated activities, Including phone barks, event Sesatanee, Maing canvassng, Surveying, or any other actly that advances the campaign of s candidate? 15. Have you ever been convicted of a felony for Which you have not received either: () a pardon; or (1) an order of expungement? Oves ®No | otense | oateot conviction | County of Conviction State of Conviction 15. ve you aware of any her Information that you believe may assist the Exhcs Commission n 39ising you Concerning your compllance with the State Government EUS Ac Eves DiNo Ifyes, please provide that information below TG divorced. fo longer memlo eo Creeqrilty Housing hothont Member of 1 Habitat £ RittCovnty w= ABC Bd Wf PHCouat The SEI and any attachments, excluding the Confidential Form, are public records. Pages of 10 Affirmation “ne formation provided i this Statement of Economic Interest and any akachments re re, Compete, 416 3CcU3te Lo the best of my knowledge and belief. nave not transfered, and will not transfer, any asset, ntaest, o propery or the purpose of concealing i from sclosure while retaining an equitable interest. {understand thet ry Statement of Economic Interest and any attachments except fo the Confidential Form regaren Unemancipated Children are public records. 1 have read and understand th following statutes: N.C.G.S. § 1634-191. Concealing or falling to disclose material information. A ing person wha knowingly conceal or knowingly fais o disclose Information thats required to be 55sec A po eenomie teres . shell be gui of » Class 1 misdemeanor and subject to disclnary ‘ction under G.S. 163A-415. N.C.G.5. § 163A-192. Penalty for false information. A filing person who provides flse information on 3 statement of economic nterest. krownd {at 1 Be Er ity of & Clos H felony and shal be subject to disciplinary acon under G.5. 1634415. © af tha 1 hve reviewed my most recently fled 2018 Statement of Economic Interest and tat a of December 31 DE ponses continue 1 be true, correc, and complete to the best of my knowledge and belle 1 affirm under penalty of perjury that the foregoing Is true and correct. A EAN) ¥N @ iN ret Signature re bu ld Lf err Submit original documents only. Do not fax or e-mail this form. The SEX and any attachments, excluding the Confidential Form, are public records. Page 10.0f 10

5 ¥ NORTH CAROLINA STATE BOARD OF a / ELECTIONS AND ETHICS ENFORCEMENT [oo Receves RECEIVED JUL 1 1 201 2018 STATEMENT OF ECONOMIC INTEREST necked for some NO CHANGE FORM 1 scomes_ lope THIS ENTIRE FORM MUST BE COMPLETED TO |... FULFILL YOUR ETHICS FILING OBLIGATION FILER'S NAME (FIRST, MIDDLE, LAST) ET lomiowe Sulfix | 4&7 Floyd 1 Huggins REASON FOR FILING (COMPLETE ALL THAT A¢PLY STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (List the complete name of all State boards on which you are serving or ae being considered / . 5 sacd /Commissio LK, Tv JUDICIAL OFFICER (speci Office) LEGISLATOR (Specty House or Senate) _ AFFRMATION — affirm tha the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and curate to the bast of my knowledge and belie, | £slso cory that have not transterred, and wi not transfer, any asset, interest, a property fo the purpose of concealing 1 {rom disclosure While retaining an equitable interes. 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemaneipated Chidren) are public record. 1 acknowledge that 1 have read and understand H.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.5. 138A-27 regarding providing false information 5 1388-26. Concealing or falling to disclose material information A fling person who knowingly conceals or knowingly fais to disclose information tha s required to be disclosed ‘on Statement of economic Interest under ths Article shll be Guilty of a Class 1 misdemeanor and shal be CUbjoct to dichiinary action under G.5. 1384-45, 5 1388-27. Penalty for alse information. A fling person wha provides fale information on a statement of economic interest a5 required under his Article | Knowing thot the Information i aise 1 guilty of Clos H felony and shall be subject to disciplinary action under Gs. 1384.45. ’ foe [14 Signature Ga Printed Rame Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form. This entire document is a public record.

+7, NORTH CAROLINA STATE ETHICS COMMISSION | ron cs commssion st or C4) 2017 STATEMENT OF ECONOMIC INTEREST | out Feces AE 919-814-3600 we. ethicscommission.nc.gou . cscommission.nc.gos Ar 000130 BA 136 THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL JF Co iis” YOUR SET FILING OBLIGATION ACscamcas ud campiete 7 - Susp. Sens Date ™ Suan. Received Dae Crees encnatfill1S, Jo FILER'S NAME (FIRST, MIDDLE, LAST) — Prefix | First Name. Middie Name Lost Name suffix {pars | Hn Flowd | Hogg. | Pos Cevnty [Covmty Commissioness [ waruRe or vee oF usines | Gorersoaet { | REASON FOR FILING (COMPLETE ALL THAT APPLY) 1 STATE GOVERNMENT JOB (Specify Agency) BOARD/COMMISSION (List complete name of all State i l | boards on which you are serving or are being consicered) | Martin Luthe £: wg Js Commosfon JUDICIAL OFFICER (Speci Office) | LEGISLATOR (spect House or senate) | A. Do other immediate family members reside in your household? Cves Ko Vihen used throughout this form, the term Immediate family includes your spouse (unless legaly separated). It iso includes members of your extended family (your and your spouse’ children, grandchildren, parents, grandgarents, and | Sings, and the spouses of each of those pervans, wha reside in your household. i List the ull name of al adults and emancipated minors In your household. A minor is a hid under 18 years old. Minors are emancipated by marriage, enSEmENt the US milter, or court order or emancipation FULL NAME OF ADULTS & RELATIONSHIP EMPLOYER JoB TITLE NATURE OF "EMANCIPATED MINORS _ | BUSINESS The SET and any attachments, excluding the Confidential Form, are public records. Page 1of 10 8. Lit ONLY the Initials of al unemancipated minors in your househald belo. A minor is child under 18 years od Note: You must lst the full name of each minor child on the Confidential Form available at the end of this document. = —— INITIALS FOR | RELATIONSHIP empLOYER 308 TITLE NATURE OF UNEMANCIPATED | ‘BUSINESS PROPERTY INTERESTS 1 As of December 31, 2016, did You, your Spouse, or members of your immegite family. | A. Have an ownership interest In North Carolina rea estate (Including your residence) with & market volue of $10,000 of more? Pye Hees al "owner of Real Estate | o% Ownership Interest Location by City Location by County Bru Fld Hogins | 50 1seSprvcestGlm | Pith fk Huggins | 573 pmSpecstGhin | ptt . pet Flopl Hoggan seas, ou fh fos bowie Cite fH ©. Lease or rent rea estate or personal property 10.9r fom he State of North Caralina with » marke value of $10,000 or more? Oves ro Name of Lessor Name of Lessee | If Real Estate, Location If Personal Property, (Renter) by City & County Describe 2. At any time during 2915 ar 2016, id you, your spouse, or members of your immediate family sell or buy from he Siate of North Carding personal property wi a market velue of $10,000 of more? Ove [he Name of Purchaser Name of Seller Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20110 FINANCIAL INTERESTS 3. A of December 31, 2016, did you, your spouse, or membecs of your immeliate family own any ofthe folowing fnencial interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY. A. Stock n a publicly onned company? TCV. RT —— . _ _ Do cat list owhersiip interests in widely Reld investment nd (ncuding mutual fonds, reguiated Investment companies, or pension or deferred compensation plans) f: (1) the fund 1s publicly traded or ts assets ore widely | diversified; and (i) nether you nor an immediate family member are able to control the assets hed 1 the mutual fund, | investment company. or pension o deferred compensation plan Owner of Interest Full Name of Company (Do not use a ticker symbol) ©. Stock Oions in & company or business? ves Kno Owner of Stock Option Full Name of Company (D0 not use a ticker symbol) | i 3 C. Interests In a non-publicly owned company or business entity (including interests in sole proprietorships, Partnerships, Imited partnerships, Join ventures, limited ability companies, mice abilty partnerships, and closely held corporations)? Dives [RNo- 1"No,” proceed to question 4 ‘Owner of Interest Name of Company or Business Entity C3). Far each non-publicly owned company or business entity (the “primary company”) dented in question 5. above, please It the nares of any other companies of business entities I which the primary company | ‘owns securities 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 §] Nore or Not Known The SEI and any attachments, excluding the Confidential Form, are public records. Page 30f 10 TC a0 you kom hat amy arpa a bine ey dn 3. a 311) above a ry eral usnass ea a a nnn Name of Company or Business Entity Geseription of Business Activity with th State hone or hot Known 4. As of December 31, 2016, 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 SE] Helpful Tips for the definition of “Vested Trust” and “Blind Trust,” Oves Rio Name and Address of Trustee PR RE LA 2 8 Br i TIAE, yo, fo Sp 2 aio 4 pe RE ore We ige oF aa om pom rom Ee rp ea woot om RYes OiNo Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit union, gs [mmpa ] SE Credit Union Churn Flegd Hagen) Credit Univne fute locas \Forst Flight Fed OE Condit Collin] Codd pion s. List each saurce of income (not specific amounts) of mars than $5,000 received by you, your spouse, of members of BA ME A AR A Lo pr CL i Rd EE bb oki See an ora vere Do nat nctiude income received from the following sources: virial ¥ Petar lim: Nira ant + Soca security income/ S501 Recisrhof Eras PE Typeor Type ot income mens; ndustry Tad a reportable income ovr 55,000 in 2016 7 p alc p | State Retive ment He tote EnployhSis Cerecnment | Ret, ve prvent Tie 3 a amy staat, svclutig th omens For, see publ resorts, rage aot 16 [Clves No - Jf “No,” proceed to question 8. » Do not list State boards or entities, or entities created by a political subdivision of the State. | Corporation or Organization Purpose of Organization CL gone or Not Known 8. During 2016, were you, your spouse, or members of your immediate family a director, officer, of governing board (2). st the name of ach company or business ih which you were associated where you a member of you immediate | family was an employee, Girector, officer, partner, proprietor, or member or manager 2s of December 31, 2016. i Name of Person Relationship to filer Nome of Company Role of Person Ao Business Associations ['516). 1 you know that any company or business entity lstec in S(a) sbave 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 a ref description of tha business actly. Name of Company or Busincss Entity Description of Business Activity with the State Not aoatcabe (ho ents ste on #93) 10. Ave you a pracicing atarmey” Dives RNo [Judicial Officer/State Attorney | 11s", check each category of legal representation in which You or the aw firm with which you ae affiated has corned legal fees of mere than $10,000 during 2016. Administrative LL Admiralty [7] Corporate Cnminat Decedent's Estates (2 Environments Utesuronce tabar | [J Local Government [Real Property. J securities. {Tax 01 Tort tigation (inctucing [kites Regulation other category not sted negiiasnce) BN 11. Quriog 2016, were you o licensed professions! (other than an attorney) or did you provide consuling services individually or 5 a member of 3 professional association or WEN you charged of were bod ver $10,007 | owe ge Type of Business Nature of Services Rendered The SEF and any attachments, excluding the Confidential Form, are public records. Page 6of 10 [42 ve you or your empover, your spouse or members of your immediate fami, or thir avoyer curently: | + Licensed by the State board or employing entity with which you are or will be associated oF i ives Til Desoto fic Yo re at rete to cml hs aston sre og Secs Toe oe es eas Oves No | OTHER DISCLOSURES - a + receive any "gift(s)" exceeding $200 per quarter from a person or group of persons acting together, and = oe alia weve vas oer vues woo lors 8 erarale pen coco oy re gen vs wre »Do not report gifts given by members of your extended family. : TT - »Do not report gifts that have previously been reported by you to the Department of the Secretary of State on the 15. During 2016 (but only the Um period ater you were appointed, employed, or led or were nominated as a candidate) did you + accept a “scholarship” exceeding $200 from 2 person or group of Persons acting together and + those person(s) were outside North Carolina and + the scholarship was related to your public poston? A “scholarship” is 8 grantein-aid, either direct or indirect, 0 attend a conference, meeting, or similor event, Including tuition, travel, 104ging, meals, and other similar expenses. | [Ces DSNo. [3 Juciciol Officer - You sre not reauired to complete this question if you are judicial ofc or you ae | lng a¢ judicial oficer appointee. | » Do not report gifts that ave previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted persons. » Legisators ae not requred to report scholarships paid by a nonpartisan leisative crganizaton of which the legislator or the General Assembly 1 a member or participant or an afiate of hat organization. Date of Name and Addrass of Donor(s) Ooscrive Event Eetimated Market Scholarship Vatue 16. Were you appointed or re you being considered fo an appointment 0 » covered board by the Governor or another Counc af State member? i Council of State members are: | > Governor > Lt Govemor » Secretary of Ste i » State auctor > State Treasurer > Superintendent of Public nstrcton » ittormey General » Commissioner of Agriculture» Commissioner of Labor » Commissioner of Insurance res Ono If “Ves”, list all contributions you (NOT immediate family members) made during 2016 with a cumulative total of more than $1,000 10 the Governor or ather Council of State member who appointed you. » Contributions are defined in N.C.G.5. 163-278.6(6) and include, bt are not itd to “any advance, conveyance, epost, Gsoutin, transfer of nds, 1030, Gan, GI, peda6 oF Usp of ane or ANNA af value whatsoever,” oate Amount Contributed to No comtrnutionts) wih 2 cumulative total of more than $1,000 J Ee The SEI and any attachments, excluding the Confidential Form, are public records Page 8 of 10 47. you an appointee or prospective appointee to: 2. the mead of principal state department (e.3. cabinet secretary) appowted by the | Governor; or | 5. a North Carolina Supreme Court Justice, Court of Agpeas, Superior or District Court Judge; or ©. a memoer of any of the following boards. + ABC Commission + Cosstal Resources Commission « State Board of Education Yes {No + State Board of Elections. + Division of Employment Security 1 Nos proceed to + Environmental Management Commission auestion 15. | + Industrial Commission + Human Resources Commission + Rules Review Commision + Board of Transportation + UNC Boao of Governors | + Utes Commission | + Wife Resources Commission . 6. 1 s0, were you appoinced or are you being considered for spporrtment tothat | []¥es No SUBIC position by 3 Cound of State member? Counc of State Members aro 15120 | 11 ono,” proceed to aveston 16 question 18. 130, you must dicate whether during 2016 you (not immediate army members) engaged in any of the following activities with respect to or on behalf of the candidate or camipargh committee of the Counc of State member who. appointed you to your public poston. Yes No 1 Collected contributions from multiple contributors, took possession of such mutole contributns, and transfered or del ered those calected Contrioutons to the car date or Committee? Contr butions are defined in auestion 16, 11. Hosted a fundrarser at your resdence of piace of usiness” Ives ine 1. Volunteered for campaign-related acties, which include, but are not mited 10, phone banks, event assistance, mailings, carves, surveying, orany | T)¥es [INo ther actvty tht oGvances the campsign of a CANGIESLES 716. Have you ever been convicted of a felony for which you have not recewed ether: (1) a pardon of innocence; o (1) an | order of expungement regarding that conaicton” | Ove ge ottense Date of Conviction | County of Conviction State of Conviction 15. Are you aware of any other information that you beizve may sist the State Ethics Commission in advising you concerning your compliance with the State Government Ethics AC? ives CIN if yes, please provide suc informaton oclow. Torr dvpri i abi Grima shevaciny Chasity [ad ZF foo | Horan B Pett Covey al 8 ie Pie BR By PFCanty The SET and any attachments, excluding the Confidential Form, are public records. Page or 10 AFFIRMATION Yom ht the information proved tis Steen of conn crest nd any atachments hereto ar ev, complet, and accuse 10 he het of, wIcgs and beet al ctf hat have mon ramen ad il not se, amy set resto prop For th pose of concen i from disclosure whi etaing an equate mires dertnd that ay Staten of conomic nts and an sche or supplements hero st the exception of he Conidentia Fun renin Unrated hide a pol 1eond acknowledge thar ave rd nd understand N C65 138-2 rr concealing or fling 1 discos merisl information and N.C GS. ITAA regarding roving tle fomaon §1380.20 Comcling or fing to disclose natal information, A sling person who knowingly conceals or knowingly i close formation thot is equine be icone on Stren of ccammie lees under his Arle shall be guy of Clas 1 isdemeanr nd shall be siect 0 Gicphary sci under G5 1NASS § IAL. Pray Ror fas information A” ling person who provides a nforion on A of economic terest rte nde this Arc Koi ht Te tormation i lc ls of a Cas H con Sod shall bt sbi 0 Gnaplnry chon ume GS TAs pee ) li Plog Mformpiiens J YAS Sramature bite fd Hogg: aa Submit SIGNED, ORIGINAL documents oly. 00 not tax ar emai this form. The SEL and any attachments, excluding the Confidential Form, are pubic records. Page 10f 10