Anne Harper Bernhardt

FOR STAFF USE ORLY PORN STATE ETHICS COMMISSION Date Recelved: CIP 2020 STATEMENT OF ECONOMIC INTEREST RECEIVED Q NO CHANGE FORM . This entire form must be completed to fulfill i your SEI filing obligation. crettaararisngaanssion OF Scanned ote Enteredin08 by Filers Name (First, Middle, Last) = 5 WEvER | Weowppee [| Reason for ilng (Complete al that apply.) State Government Job (Specify agency and position) | Board/Commission (List the complete names of ail State boards on which you are serving or are being considered.) rr] pein TE Judicial Officer (Specify office.) Legislator (Specify House or Senate.) AFFIRMATION have carefully reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue to be true, correct, and complete to the bast of my knowledge and belief. have not transferred, and wil not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest understand that my No Change Form is a public record. Ihave read and understand the following statutes: N.C.G.S. 5 1384-26. Concealing or ailing to disclose material information. filing person who knowingly conceals or knowingly fails to disclose information that s 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.. 138-45. N.CG.S. § 1383-27. 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 o a Class H felony and shall be subject to disciplinary action under G.5. 1384-45. T affirm under penaity of perjury that the foregoing is true and correct, Br Neogn Reh A ao 9) Sidnature oa Pons MHP BrawesT Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a public record.

m oR STARE USF OY GEN STATE ETHICS COMMISSION Poe EEE J Arie EIVED A.#/) 2019 STATEMENT OF ECONOMIC INTEREST ‘2300 . NO-CHANGE FORM tees for compen 12 STAT! TE This entire form must be completed to fulfill your Snes BDAROQE ELECTIONS ethics filing obligation. rare On Fier Nome (Fre, Wide, Los) btn |_prstame | rita ams | mL — wo su | wes | Be WRARIER TRERINARIT eason for Fig (Complete al hat 3p ‘aard/Commission (List the complete names of ll State | Be DRRD bE ORECERS I | 11%: 4 Soda Officer Specty office.) Legstotor (Speaty House or Senate.) | AFFIRMATION — — he information provided inthis Statement of Econamic Interest and any attachments are (re, Comets, and Scurate to Tne bat of my knowedge and betel. 1 have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure 1 he retaining on eauanle ierest understand that my Statement of Economic Interest and any attachments except or the Confidential For Regarding Unemoncipated Chidren push records. Ihave read and understand the folowing statues: A flog person who knowingly conceals or knowingly falls to discos information that fs required 1 be disclosed on eo economic meres shall be guilty of 8 Clas 1 misdemeanor and. subject to discighnary action nde G5. 168Aa1S. NCGS. § 1634162. Penalty for fase information. ! A filing person who provides false information on a statement of economic interest . . . knowing that the information 1 a ey aka lace 1 ely and snl bo Subject to disciplinary action under G5. 1634-415 2 affirm that 1 have reviewed my most recently fied 2018 Statement of Economic Interest and that as of ss Joka, wr responses continue to be rue, correct, and complete to the best of my knowledge and Detit. Laff under penalty of perjury that the foregaing is true and correct. I Nop Wa EA | Signatre Ba Cit tamed, original documents only. Do not fax or e-mail tis farm. This entire document i a public record.

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 Mrs. anne harper bernhardt 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) UNC Health Care System Board of Directors; 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 1/26/2018 Signature Date anne harper bernhardt Printed Name The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 2

NORTH CAROLINA STATE ETHICS COMMISSION [ot coi ERY | Date Received: & 2017 STATEMENT OF ECONOMIC INTEREST | NO CHANGE FORM Chad cnet tr comgetan 10 THIS ENTIRE FORM MUST BE COMPLETED TO {scanned Date. FULFILL YOUR ETHICS FILING OBLIGATION ne FILER'S NAME (FIRST, MIDDLE, LAST) _ [V} Biohe. Pen | VhsRowRROUC STATE GOVERNMENT JOB (Specify Agency and Position) BOARD/COMMISSION (List the complete name of all State UNC WERTIRCARE "AFFIRMATION — eee HX Agree _— hy JI NE WRAY Pal, en) Pine NERPER 13ERUSIET | Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form.

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 Mrs. anne harper bernhardt 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) UNC Health Care System Board of Directors; 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 3/1/2016 Signature Date anne harper bernhardt Printed Name The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 2