Archilus L. Hart
Agriculture & Consumer Services, Department of
Filings
2025 Agriculture & Consumer Services, Department of
Document text
Fo STAFF USE OLY
Gp STATE ETHICS COMMISSION Oat Received:
A -
U3) 2025 STATEMENT OF ECONOMIC INTEREST RECEIVED
7 No Change Form
This entire form must be completed to fulfill
your SEI filing obligation. NC ETHICS COMMISSION
File’ Name (First, Midd, Lost
Cp ——f Soft
Reason for Filing (Complete all that apply.)
Sere Government oo lng Fos Sani (Spec 330m and | Board Commission Lis the cet res f Ste ends
Poanion) arn You a SIN 0 fo ech yo re Di conser)
Corry Soe 5S Tala Oar oF Pos Savi Carty Sri 53 egos o Fil Pos Saves
(Spec fice) Spey House ar Sensie)
AFFIRMATION
1 have carly reviewed my mt recently ied Statement of Economic Interest Long Form and my responses continue
10 be true, correct, and complete o th best of my knowiedge and belef
1 have not transferred, and wil not transfer, any asse, interest, or property for the purpose of concealing it from
disclosure whi reining on equiabe interest.
1 understand that my No Change Form s a public record.
nave read and understand the folowing statutes:
N.C.G.5. § 138A-26. Conceaing or falling o disclose material information.
A fing person who knowingly conceai or knowingly ails to cscose information tht i required o be disclosed
on a statement of economic Interest . . hal be uty of & Class 1 misdemeanr and . subject to cscplinary
action under G.5. 139A.45.
N.C.G.5. § 138A-27. Penalty for aise information
A fing person who provides fase information on statement of conomic interest knowing tha the
information fale s uiy of Class felony and shal be subject to disciplinary action under G.5. 138A-45.
I affirm under penalty of perjury that the foregoing is true and correct.
2 ALL Zl
Signature ewe
FE
‘Submit signed, original documents only. Do not fax or e-mail this form.
“This document s a public record.
2024 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2024 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
Mr. archilus Hart
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 the complete names of all State
boards on which you are serving or are being considered.)
Agriculture & Consumer Services, Department of - Special
Assistant to Commissioner of Agriculture
Judicial Officer or Filing Post-Service (Specify office.) Legislator or Filing Post-Service (Specify House or Senate.)
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 04/09/2024
Signature Date
archilus Hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2023 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2023 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
archilus Hart
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 the complete names of all State
boards on which you are serving or are being considered.)
Agriculture & Consumer Services, Department of - Special
Assistant to Commissioner of Agriculture
Judicial Officer or Filing Post-Service (Specify office.) Legislator or Filing Post-Service (Specify House or Senate.)
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 04/10/2023
Signature Date
archilus Hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2022 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2022 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
Mr. Archie Hart
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 the complete names of all State
boards on which you are serving or are being considered.)
Agriculture & Consumer Services, Department of - Special
Assistant to Commissioner of Agriculture
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
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 04/29/2022
Signature Date
Archie Hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
This entire document is a public record.
2021 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2021 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
Ms. archilus lloyd hart
Reason for Filing (Complete all that apply.)
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Agriculture & Consumer Services, Department of - Special
Assistant to Commissioner of Agriculture
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
AFFIRMATION
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipated Children public records.
I have read and understand the following statutes:
N.C.G.S. § 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 that I have reviewed my most recently filed 2020 Statement of Economic Interest and that as of
December 31, 2020, my responses continue to be true, correct, and complete to the best of my knowledge
and belief.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 04/12/2021
Signature Date
archilus lloyd hart
Printed Name
2020 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2020 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM
This entire form must be completed to fulfill your
ethics filing obligation.
FOR STAFF USE ONLY
Date Received:
Checked for completion ______
Scanned _______ Date______
Entered in DB ____by______
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Mr. archilus hart
Reason for Filing (Complete all that apply.)
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Agriculture & Consumer Services, Department of - Special
Assistant to Commissioner of Agriculture
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
AFFIRMATION
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipated Children public records.
I have read and understand the following statutes:
N.C.G.S. § 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 that I have reviewed my most recently filed 2019 Statement of Economic Interest and that as of
December 31, 2019, my responses continue to be true, correct, and complete to the best of my knowledge
and belief.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 05/18/2020
Signature Date
archilus hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2019 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2019 STATEMENT OF ECONOMIC
INTEREST
NO-CHANGE FORM
This entire form must be completed to fulfill your
ethics filing obligation.
FOR STAFF USE ONLY
Date Received:
Checked for completion ______
Scanned _______ Date______
Entered in DB ____by______
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Mr. archilus lloyd hart
Reason for Filing (Complete all that apply.)
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
boards on which you are serving or are being
considered.)
Agriculture & Consumer Services, Department of - special
assistant to Commissioner of Agriculture
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
AFFIRMATION
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipated Children public records.
I have read and understand the following statutes:
N.C.G.S. § 163A-191. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed
on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary
action under G.S. 163A-415.
N.C.G.S. § 163A-192. Penalty for false information.
A filing person who provides false information on a statement of economic interest . . . knowing that the
information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415.
I affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of
December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge
and belief.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 06/03/2019
Signature Date
archilus lloyd hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2019 Agriculture & Consumer Services, Department of
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2019 STATEMENT OF ECONOMIC
INTEREST
NO-CHANGE FORM
This entire form must be completed to fulfill your
ethics filing obligation.
FOR STAFF USE ONLY
Date Received:
Checked for completion ______
Scanned _______ Date______
Entered in DB ____by______
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Mr. archie hart
Reason for Filing (Complete all that apply.)
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
boards on which you are serving or are being
considered.)
Agriculture & Consumer Services, Department of -
agriculture program specialist
Judicial Officer (Specify office.) Legislator (Specify House or Senate.)
AFFIRMATION
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate
to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipated Children public records.
I have read and understand the following statutes:
N.C.G.S. § 163A-191. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed
on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary
action under G.S. 163A-415.
N.C.G.S. § 163A-192. Penalty for false information.
A filing person who provides false information on a statement of economic interest . . . knowing that the
information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 163A-415.
I affirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of
December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge
and belief.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 02/25/2019
Signature Date
archie hart
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2018 Agriculture & Consumer Services, Department of
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
archilus Lioyd Hart
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)
Agriculture & Consumer Services, Department of
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 4/10/2018
Signature Date
archilus Lioyd Hart
Printed Name
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2
2017 Agriculture & Consumer Services, Department of
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
archilus lloyd hart
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)
Agriculture & Consumer Services, Department of
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 4/19/2017
Signature Date
archilus lloyd hart
Printed Name
The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of
2
2016 Agriculture & Consumer Services, Department of
Document text
7, NORTH CAROLINA STATE ETHICS COMMISSION iz: vis Compassion oy
ny De Reco:
Gl & 2016 STATEMENT OF ECONOMIC INTEREST |
0 CHANGE FORM WL :
THIS ENTIRE FORM MUST BE COMPLETED TO scanned Date
FULFILL YOUR SEI FILING OBLIGATION y
FERS NAME (FIRST, MIDDLE, AST) |
Prefix FirstName | Middie Name | Lost Name Suffix
(rete Femnems | Sedeewe | ___ terweme. SE
Rech, lus Geek) Loyd) Hardt |
EASON FOR FILING (SELECT ALL THAT APPLY) ) .
| ESTATE GoveRHENT 108 (pease pect the agency for | (]BOARD/COMMISSION (Flease lst complete rome of al |
‘Which you work or are being considered) State boards on which you are serving or are being
Leman
| Asi enture |
UDICIAL OFFICER (Please speci the office you hold) | J LEGISLATOR (lease spec House or Senate)
| |
AFERMATON
fir that the informaion provided in this Statement of Economic Interest and any attachments hereto are true,
| compet, ans accurate o the bes of my knawkdae and belt.
also corti that 1 have nt transferred, and will not transfer, any asset, interes, o property fo the purpose of concealing
Ie rom disclosure while retaing an equtoble terest.
| understand that my Statement of Economic Interest and any attochmerts o supplements thereto (ith the eccepton of
the Confidential Farm regaring Unemancpated Chidren) are public cord.
Lacknoledge that 1 have read and understand N.C.G.5. 1384-26 regarding concealing o fling to disclose material
formation and N.C.G.5. 138A-27 regarding providing false information:
| § 1384-26. Concealing or failing to disclose material information.
A Hing person who knowingly conceals or knawinly ai to disclose information tht is required to be disclosed on
Pearman af cconome mierest under this Ace shal be guity of » Class 1 misdemeanar and shal be subject to
| dscinary scion under G.5. 136A-45,
8138-27. Penaty for fale information.
A fling person who provides false information an a statement of economic Interest a required under this Article
Knowing that th Inermation 1 ale 1 Guilty of a Class H felony and shal be subject 1 discipinary action under
| pate)
T 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 10 pe true, correct, and complete to the best of my knowledge
na beter
ree 1
/ /
| A Gad 4sa/mor é |
Signature Gate
Prehie Hart |
| hinted Name
Submit SIGNED, ORIGINAL documents only. Do not fox or email this form. |
This entire document is a public record.
2015 Agriculture & Consumer Services, Department of
Document text
© 7%. NORTH CAROLINA STATE ETHICS COMMISSION
"J: 2015 STATEMENT OF ECONOMIC INTEREST
7
NO CHANGE FORM
FILER'S NAME (FIRST, MIDDLE, LAST) |
First Name [wide Name Last Name Suffix
y Lloyd . far 4
REASON FOR FILING (SELECT ALL THAT APPLY) }
STATE GOVERNMENT JO (Please specify the agency for | [] BOARD/COMMISSION (Please ist complete name of all
Which you work or ae being considered) State boards on which you are serving or ore being
considered) ‘
NE Qh. of Apecotore.
{C3 UBICIAL OFFICER (Please specity the office you hold) _| [J LEGISLATOR (Please speciy House or Senate)
AFFIRMATION
| 1 affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true,
Completa, and sccurate to the best of my knowledge and belel.
als certify that I have not transferred, and will no cansfer, any asset, interest, or property fo the purpose of concealing
irom isclosure whi retaining an equitable Interest.
understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of |
tne Confidential Form regarding Unemancipated Children) are public record
{acknowledge that 1 have read and understand N.C.G.S, 1384-26 regarding concealing o failing to disclose material
Information and N.C.G.5. 138A-27 regarding providing flse information:
§ 1384-26. Concealng or falling to disclose material information.
A filing person who knowingly conceals ar knowingly fals to disclose information tha is required to be disclosed on
2 Statement of economic interest under this Article shall be gui of » Class 1 misdemeanor and shall be subject to
Gscipinary action Under G.5. 136A4S.
5 1384-27. Penalty for false information.
A fing person who provides false information on a statement of economic interest as required under this Article
Knowing that the Information ¢ false 1 uily of a Class H felony and shall be sublect to disciplinary action under
Gs. T38A45.
I hereby affirm that 1 have reviewed my most recently filed 2014 Statement of Economic Interest and that as
of December $1, 2014, my responses continue to be true, correct, and complete to the best of my knowledge
and belief.
#1 Agree
2 Hark Yiv/2005
Printed Name Tate
Ha / a ‘Submit SIGNED, ORIGINAL documents only.
Do not fax or email this form.
Sionature
This entire document is a public record.