Anthony "Tony" Derek Hunt

This entire document is a public record. STATE ETHICS COMMISSION 2025 STATEMENT OF ECONOMIC INTEREST NO-CHANGE FORM 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 Anthony Hunt 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 the complete names of all State boards on which you are serving or are being considered.) Sandhills Community College Trustees Judicial Officer, Post-Service Filer, or Appointee (Specify office) Legislator, Post-Service Filer, or Appointee (House or Senate) This entire document is a public record. AFFIRMATION I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue to be true, correct, and complete 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 No Change Form is a public record. 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 04/11/2025 Signature Date Anthony Hunt Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 STATE ETHICS COMMISSION 2024 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 Mr. Anthony Hunt Current Employer Job Title Lumbee Tribe of North Carolina Director of Client Services Nature or Type of Business Work for our Tribal Government. 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 (Specify agency and position.) Board/Commission (List complete names of all State boards on which you are serving or are being considered.) Sandhills Community College Trustees Judicial Officer or Judicial Officer Appointee(Specify office.) Legislator 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 Dena Hunt Spouse First Health of Carolinas Dental Office Manager Manage dental clinics for Moor Regional Hospital. 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, 2023, 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 (Self plus Spouse) 100.00% Raeford Hoke 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 2022 or 2023, 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, 2023, 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, 2023, 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 2024 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, 2023, 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.) 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 2023. 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 I had no reportable income over $5000 in 2023. The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Professional and Civic Relationships 7(a). During 2023, 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 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 2023, 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, 2023. 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, 2023, 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 2023. ☐ 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 2023, 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 2023, 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 2023, 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 2023 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 2023 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 02/20/2024 Signature Date Anthony Hunt Printed Name

} NORTH CAROLINA STATE BOARD OF taped | # J ELECTIONS AND ETHICS ENFORCEMENT i Date Recenea: 2 2018 STATEMENT OF ECONOMIC INTEREST NH Checked tor comgiation Seon {A “THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL {thse on he ” YOUR SEI FILING OBLIGATION [remen | Ertered is dasha 018 ay NY ARS we es NE US EE — [profix | First Namo. esis ET EET ET SY Ea ET CR | Libs Covsdy Jk 20s] pod Govan cies pr i beaten oo I I re ania res wane | "ATION | eee | weer Dons Honk | wife . a Her sengper] Fentul offre } ITI A I he SE2 an any atach ments, excling th Conidontal Form, ae pubic recor. J— INITIALS FOR RELATIONSHIP | EMPLOYER | sosmme | watureor me | | | I * | {1 Ax of Dicamber 31. 2017. dit vou, your spouse, or members of your iEncdiats fori TTR Ey IN I 1 | ithasy lust —— Rte | phe | TT T TT | Nameoftessor | Nameoflessee | If Real Estate, Location | If Personal Property, [zn any tme during 2015 or 2017, did you, your spouse, or members of your [rmadiats farly sell to ar fy fram the | ove me” Nama of Purchaser Nomootseler | Typeotpropeny | | | FINANCIAL INTERESTS | 3: As of Dacemic 3, 2017, 4d you, your spouse, or mombers of your immediate family owe any of the faloning Francia Interests valued at $13,000 or more LIST EACH COMPANY INDIVIDUALLY, [ETN A— ==. | ¥0 00 st ownersip inieredts in » wiioly held Investment fond (eluding mutual Funds, reauiated investment companies, or pension or defemd Campanation plane) 1. (1) The fund I PUI aed 5 52 asec re dy | versie ana (i) neither you nor an immediaks family member an abi to Sono! th assets mld i ne somes urd, investment company. peraisn or Gelrred CompenSHYOR pan Ir owner of Toterest Full Name of Company (Do not use a ticker symbol) _ - EE — I — ee 5. Sack Oations in a company o business? | Ov pr — “Owner of Stock option. Full Name of Company (Do not use a ticker symbol) ME + seme} sms mete ee — Interests in 090-publcly owned company or business entity (including interests in sole proprietorsh ps, 1 partncrshigs, mite oartnrships, Jo: ventures, ted Laity compos, ited 1401s paris, and Closely he corporations? | Cives 46 - 57%," races to aueston +. _ Ownerof interest T Name of Company or Business Entity | | { Tr co EE J 1 C8) arco ruby nd company or business ery th primary company) eres» avetion | S.C abcve, pie 1st tre ns of ay Bier Compare of kines EACH me PONY Sony | ons secures or equty arests valued 3 ost $16,000. 7 known, ” 3 | Non-Publicly Owned Company or Business Entity Other Companies in which the Primary Company | he mary Company) ‘Owns Security or Equity Interests Bi Lone or Not Known The SEI and any attachments, excluding the Confidential Form, are public records. Page 3of 10 ‘Gealings or business contracts with the Stale of North Carolina, or 1 regulated by the State, provide a brief | Do not Ist assets held in bind trusts. See 2012 SEI Helpful Tips for the definition of "Vested Trust” and “Bind Trust,” ives QA | Name and Address of Trustee Description of the Trust Your Relationship to the Trust | A | J mre —————— | 5. 2s of December 31, 2017, did you, yout spouse, or members of your immediate family have Liabilities of $10,000 or ‘Name of Debtor (You, Spouse, Immediate Family I Type of Creditor (Commercial Bank, Credit Union, "Lit cach sourcs of income (not specific amounts) of mare Shan $5,000 received by you, you: spouse, or members of | Recpientof Income | Name of Source. Type of Type of ncome | [Autos Hell flor Coty Slay] Ftocnd | salary Hathecey” Hoo fhe Cuts Gout | Goeorent | say Pena Hart : First peclth Go Dente {| Slay PROFESSIONAL AND CIVIC RELATIONSHIPS 74a). DADS. 2017 we you, your gouse or members of your Immediate aly 3 rector ace. governs boa ramet, Eloy, AGEN sadn, of 13 SATad HR 3 SO Coors rea nd a Sac of Roth Corer primary Feu hob ST, Hea, So mn Sos amEND BIOL feb Gives ro 1180," proceed to question 5 D0 nc ft Sate pa or sre, or anus retod by plc USN BS > Bo ro lst organisms of whic you sre a mars members | Name of Person | His/Her Position | cor Nome of Nonprofit "Nature of Business or " | PON | corparanan or Orgmmrastion | pumare or rameter | EE a — r - - oo - o a —T 700). 11 the nonprofit corporations or organizations sted above do buses with the State of North Carols o recon | State hinds, please provide a brief description of the nature of that business, if known or with which due diigence could or o ot Knew . BURG 01, WE VO, your $p0e, Bo you [age my eer, oo sori bod | member Of ay Sty or3NASto, 0 Sua 35 Bo MRS hr So Wh yo ry Bern | Toe Cives 6 Ceqttor uc offices - You ore not rus to complete ths queen i you are ig because you are a legislator or a jucicial officer ar you are filing as an appointee to thase offices. | 00 not ist organizations of which: you are any & member (not Serving in 2 leadership role). | [7 name or person | Name of Saciety, Organization | Leadership Position i or avert Crous iector, Oricer, Buta Member) Th SE and any attachments, excluding the Confidential Form, ar public records. Pagesar to amy as ore, rector, She, Boer, op, eve 0 manage 5 of DeGerhe 11 S1 | wameotpeson | Remon torier | Nameofcompany | Roloof erson Rs = r— - = —— np a: ! | | (0.1 yo eno ha ary compar or busines ny sted 1 5() above ad any tara buses lng or Bias) cori wh 1 Ske of North Cares 7 was reed othe Stole ms of Deceit 31. Sor proctle 3 Name of Company or Business Entity Description of Businass Acthvity with the State fon opptcable (ho ees sted on £34) Fr pp—— Fives 2 [1 udcl Offcarstote Atormey i Vex. chck ech cotegary cf al representation i chy rh ov ih hich yo re TSG has core Tego eis of mre. hom 40.000 Sui 2013. | DO neminstratve Lhamiety comer Sr Decedent's ssttos 3 Enrormenta Yeosurance Daher toca Goernmens 0 Rest property [I seruntes Omer | | C170 ination ticutng tes seauition Other category ot es ay (dudes 2 ties Retin mers oo Type of Business. Nature of Services Rendered BN i The SEL an any attachments, excluding the Confidential Form, are public records. Page sor 10 + Regulate bi the Stale bod or employing entity with wich yo re o wil be ssocited or | Name of parson Nome of Employer Type of Relationship | EE BN 1 | ves Nfs Somme prem orm Daeor | Regiswation Registration | Expiration A SS —— - HE lomerosciosores | + receive any “3ik(a)" exceeding $200 per quarter from a person or grup of proms acting together, and | + when both you and those person(s) ware outside North Carolina at the time you accepted the gift(s), and ean | ¥ 00 not report gifts given by mumbers of your extended family. oo +00 not report gifts that have previously been reported by you to the Department of the Secretary of State on the | Date Item Received | Name and Address of Donor(s) Describe Item Received Estimated Market I i i | | The SEE am ny atachmats, exuding the Gomi Form, ave public record. Pose ot 0 15 During 2017 (ut ony the ma pariod ate you rc appointed, ermpiyed, of ied or ward marinated a5 3 conde | 6 vou + BECP a “scholarship” exceeding $200 rom a person or group of persons acting together and these persnte) were outside orth Caron and + the scholaralip was E11sd t your bUbHE POSION? A "scolar 5a rant-in-ald, either direct o indirect, 10 attend a conference, meeting, or Similar event, including tuition, travel, ding, mess, and snes Shilar expenses. £3 ¥es fc Cuil Offices You are cot red compete tis seston you ae cial otis or you are (ing 5» usin acer sppotores > 0 nt report gts tht have previously been reported by you to the Deparment of the Secretary of State an the Frenne Report Io Ercmprad pereome > Logitors or na cui report cholrshs pad by 5 nonparizn lee organization of wich ne legion | or the General Assy 5 ¢ MTSE or DACIEGNt or 30 ate of tha organisation | Dateor | Name and address of Donor(a) Describe Event Estimated Market | schotarshin Valve | r T 16. Were you appointed or are you being considered for an appoNIENt to a covered board by the Governor of another | Com of Sate memmers | Councit of state members are: » Governor » Lx. Governor > Secretary of State IR + Sas > Superintendent of Publ struction | » tore General > Commissioner of Agrcuiture Commissioner cf Labor » Commissioner of swore Ove © total of more than $1,000 fo the Governar or other Cound of State member whe sperms roe. > Contributions ae asfned n .C.G.. 163-278,6(6) ind inch, but ars not mite to, “any advance, conveyance, epost, detebuion, Srante of unde, an, payment, ait, D406 or psc pion of oe a SNS ov presse Tome Amant Contributed to LL No contributions) ith 3 cumultive otal of more than $1,000 [Lire A — The SEE and any attachments, excluding the Confidential Form, are publi records. Pages of 10 17: As you an appantee or prospective appointee to: | | the head of principal state department (6.g. cabinet secretary) appanted by te | 1 Governor of i |b. 3 orth Corona Supreme Coun ust, Court of Appts, Superior or Distr [I | tna . a mart of any of the following bosras: | + AGC Commision | | ~ Conta Resources Commision © State Bond of Education [ves ofa © Ste oan of lectan. | + Division of Emaloyment Security It “No proceed to + Environments) Management Comission auestion 15. ! + Industrial Commission | + Human Resources Commission ! | fuk nv Commoner {| Z BowctTanpononon © URC Bor of Governors © Utes Commission bpm ______________ | _____ d. I 50, were you appointed or are you being considered for appointment to that ves [No li | ple per 3 Counc of Ste amr Couns o Sho mmr ed | on raced ta | | Guestion 15. | | 50, you must cate wht suring 2017 vau (nt mms my ] rember) na2924 nny of te oll ates wh 25k or or ei of | | he Canidae or compton commie of to Count of ove emer re | Sepa ou 1 Your lc podem: Ces (M0 | i. Collcted contributions from lip cotriutrs, took sossesaon of sch | TUTOR conrbuans, and rans of debe in coteci Conon 0 th conde o commie? Contriborens ae suid in miton 15. | i Homat fndrmser a you resdance or ioc of es” Cves (ve i. Volieered for campaign relate scities, wheh incu, bu are nc ied 1, hare baie, evant Sssstance, mainos, camissing, Savon, or ony + | (Ives [Io | he sii na atesrces the em of 5 co nt | 15. Nava 1 ever Goan comictod ofa lon fr which you hn nt rec her: a pavaan a nocenc o 1 27 order of expungement regarding that conviction? 1 | Ove of | | offense Date of Conviction | County of Canviction | State of Conviction 19. Ar you ware of any other information tha you bee may asa the State £4 Commision in sdvsng you | Conan or comptance A he Sine Gone en Fen aS A — 1 | | The SEX and any attachments, excluding the Canfidential Farm, ar public records. Pagesor io AFFIRMATION | Taff tht the information rove in Us Statement of Economie terest and any suchen bre sree, opie, sho crf ht has ad rs. amd will st, sy ss, rs, property fo the purpose of concealing inrmtion and N.C GS. ISSA regarding prong fe formar § 1387-26. Concealing or failing to disclose nxaterial information. | | dicimary action nds 5. 198505 FT (A OD 4S Stofasrs I Es ee Er Hlithoiy D. Hut . Fried tome | Submit SIGNED, ORIGINAL documents only. Da not fox or ama this form, Lo The SEL and any attachments, excluding the Confidentil Form, are public records. Page 1001 10