Augustus M. Black, Jr.

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 Mr. Augustus Melton Black JR Current Employer Job Title Colibri Group & Of Counsel to Everett Gaskins Hancock LLP via A. Melton Black, Jr. Atty at Law, PA Educator and Attorney Nature or Type of Business Education and Law 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.) Real Estate Commission 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 Andrew M Black Child Chili's Employee Restaurant Marion T Black Child Piedmont Wildlife Center Intern Wildlife Center 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston Augustus Melton Black JR (Self) 60.00% Wilmington New Hanover 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 Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) CG Parent Holdings, LLC Augustus Melton Black JR (Self) Project 22, LLC 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 CG Parent Holdings, LLC Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Project 22, LLC SouthCity Title Company, LLC 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 A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Appraisal and real estate education. Regulated by the State SouthCity Title Company, LLC Title Insurance. Regulated by the State. CG Parent Holdings, LLC At least two companies owned by this entity are regulated by the state. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 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 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.) 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 Augustus Melton Black JR (Self) North Carolina Real Estate Commission Government Other type of income Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income Augustus Melton Black JR (Self) Colibri Group Education 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 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 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 Andrew M Black Child Chili’s Grill & Bar Employee Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self Colibri Group Employee Augustus Melton Black JR Self CG Parent Holdings, LLC Partner Augustus Melton Black JR Self Project 22, LLC Partner 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 A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. CG Parent Holdings, LLC Appraisal and real estate education. Regulated by the State. Chili’s Grill & Bar None or Not Known Colibri Group Appraisal and real estate education. Regulated by the State. Project 22, LLC 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 Business/Commercial Litigation, Bankruptcy, and Education. 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. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) Colibri Group/CG Parent Holding, LLC/Superior School of RE Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 No Contributions 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 03/16/2025 Signature Date Augustus Melton Black JR Printed Name

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. Augustus Melton Black JR Current Employer Job Title Colibri Group & Of Counsel to Everett Gaskins Hancock LLP via A. Melton Black, Jr. Atty at Law, PA Educator and Attorney Nature or Type of Business Education and Law 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.) Real Estate Commission 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 Andrew Melton Black Child Student 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston Augustus Melton Black JR (Self) 60.00% Wilmington New Hanover 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 Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) CG Parent Holdings, LLC Augustus Melton Black JR (Self) AndMarb LLC Augustus Melton Black JR (Self) Project 22, LLC 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 CG Parent Holdings, LLC Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Project 22, LLC SouthCity Title Company, LLC 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 A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Appraisal and real estate education. Regulated by the State SouthCity Title Company, LLC Title Insurance. Regulated by the State. CG Parent Holdings, LLC At least two companies owned by this entity are regulated by the state. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 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 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 Augustus Melton Black JR (Self) North Carolina Real Estate Commission Government Other type of income Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income Augustus Melton Black JR (Self) Colibri Group Education Salary 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 Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self AndMarb LLC Partner Augustus Melton Black JR Self Colibri Group Employee Augustus Melton Black JR Self CG Parent Holdings, LLC Partner Augustus Melton Black JR Self Project 22, LLC Partner 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 A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. AndMarb LLC None or Not Known CG Parent Holdings, LLC Appraisal and real estate education. Regulated by the State. Colibri Group Appraisal and real estate education. Regulated by the State. Project 22, LLC 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 Business/Commercial Litigation, Bankruptcy, and Education. 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. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) Colibri Group/CG Parent Holding, LLC/Superior School of RE Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 No Contributions 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 04/12/2024 Signature Date Augustus Melton Black JR Printed Name

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 STATE ETHICS COMMISSION 2023 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. Augustus Melton Black JR Current Employer Job Title Colibri Group & Of Counsel to Everett Gaskins Hancock LLP via A. Melton Black, Jr. Atty at Law, PA Educator and Attorney Nature or Type of Business Education and Law 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.) Real Estate Commission Judicial Officer or Filing Post-Service (Specify office.) Legislator or Filing Post-Service(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 Andrew Melton Black Child City of Raleigh Parks Operations Specialist Parks and Recreation 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, 2022, 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston Augustus Melton Black JR (Self) 60.00% Wilmington New Hanover 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 2021 or 2022, 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, 2022, 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 ►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 Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) AndMarb LLC Augustus Melton Black JR (Self) MB22, LLC Augustus Melton Black JR (Self) Project 22, LLC Augustus Melton Black JR (Self) CG Parent Holdings, LLC 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 CG Parent Holdings, LLC Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Project 22, LLC Advance Title Company Project 22, LLC SouthCity Title Company, LLC 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. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. Full list is unknown to me. McKissock Learning and Superior School of Real Estate are owned. Appraisal and real estate education. Regulated by the State CG Parent Holdings, LLC At least two companies owned by this entity are regulated by the state. SouthCity Title Company, LLC Title Insurance. Regulated by the State. 4. As of December 31, 2022, 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 2023 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 5. As of December 31, 2022, 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 2022. 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, suvivors, or disability benefits Recipient of Income Name of Source Type of Business/Industry Type of Income Augustus Melton Black JR (Self) North Carolina Real Estate Commission Government Other type of income Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income Augustus Melton Black JR (Self) Colibri Group Education Salary Augustus Melton Black JR (Self) Project 22, LLC General Business Business income Augustus Melton Black JR (Self) CG Parent Holdings, LLC Education Other type of income The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Professional and Civic Relationships 7(a). During 2022, 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 2022, 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, 2022. Name of Person Relationship to Filer Name of Company Role of Person Augustus Melton Black JR Self MB22, LLC Partner Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self AndMarb LLC Partner Augustus Melton Black JR Self Colibri Group Employee Augustus Melton Black JR Self CG Parent Holdings, LLC Partner Augustus Melton Black JR Self Project 22, LLC Partner 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, 2022, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. AndMarb LLC None or Not Known CG Parent Holdings, LLC Appraisal and real estate education. Regulated by the State. Colibri Group Appraisal and real estate education. Regulated by the State. MB22, LLC None or Not Known Project 22, LLC 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 2022. ☒ 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 Business/Commercial Litigation, Bankruptcy, and Education. 11. During 2022, 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 Project 22 LLC Mentoring, Training, and Education 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. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) Colibri Group/CG Parent Holding, LLC/Superior School of RE Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 2022, 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 2022, 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 2022 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 No Contributions 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 so, 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 so, you must indicate whether during 2022 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 04/11/2023 Signature Date Augustus Melton Black JR Printed Name

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 12 STATE ETHICS COMMISSION 2022 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. Augustus Melton Black JR Current Employer Job Title Colibri Group & Of Counsel to Everett Gaskins Hancock LLP via A. Melton Black, Jr. Atty at Law, PA Educator and Attorney Nature or Type of Business Education and Law 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.) Real Estate Commission Judicial Officer (Specify office.) Legislator (Specify House or Senate.) A. Do other immediate family members reside in your household? ☒ Yes ☐ No On this form, ”immediate family” includes your spouse (unless legally separated). 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 Andrew Melton Black Child None Marion Tracy Black Child Starbucks Employee Coffee The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 12 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, 2021, 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston Augustus Melton Black JR (Self) 60.00% Wilmington New Hanover 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 2020 or 2021, did you or any members of your immediate family sell to or buy from the State of North Carolina personal property worth $10,000 or more? ☐ 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 12 Financial Interests 3. As of December 31, 2021, 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 ►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 Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) SouthCity Title Company LLC Augustus Melton Black JR (Self) Advance Title Company Augustus Melton Black JR (Self) AndMarb LLC Augustus Melton Black JR (Self) BrightPath Education Services, LLC/MB22, LLC 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 BrightPath Education Services, LLC/MB22, LLC CG Parent Holdings, LLC 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. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 12 Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. CG Parent Holdings, LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. BrightPath Education Services, LLC/MB22, LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title Company LLC Title Insurance. Regulated by the State. 4. As of December 31, 2021, 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 2022 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” https://ethics.nc.gov ☐ Yes ☒ No Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2021, 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. ☐ 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 2021. 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. Please remember to disclose your receipt of salary or wages from any governmental or private entity. Do not include income received from the following sources: ► Capital gains ► Federal government retirement ► Military retirement ► Social security income/SSDI Recipient of Income Name of Source Type of Business/Industry Type of Income Andrew Melton Black (Child) City of Raleigh Government Salary Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income Augustus Melton Black JR (Self) Raleigh Regional Association of Realtors Education Professional fees Augustus Melton Black JR (Self) BrightPath Education Services, LLC/MB22, LLC Education Other type of income Augustus Melton Black JR (Self) Colibri Group Education Salary Augustus Melton Black JR (Self) North Carolina Real Estate Commission Government Other type of income Augustus Melton Black JR (Self) SouthCity Title Company, LLC Title Insurance Business income The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 12 The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 12 Professional and Civic Relationships 7(a). During 2021, 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. ► 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 2021, 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 7 of 12 9(a). List the name of each business with which you were associated where you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2021. Name of Person Relationship to Filer Name of Company Role of Person Marion Tracy Black Child Starbucks Employee Augustus Melton Black JR Self BrightPath Education Services LLC/MB22, LLC Manager Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self SouthCity Title LLC Partner Augustus Melton Black JR Self Advance Title Company Partner Augustus Melton Black JR Self AndMarb LLC Partner Augustus Melton Black JR Self Colibri Group Employee Augustus Melton Black JR Self CG Parent Holdings, LLC Partner 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, 2021, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. AndMarb LLC None or Not Known BrightPath Education Services LLC/MB22, LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. CG Parent Holdings, LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. Colibri Group Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title LLC Title Insurance. Regulated by the State. Starbucks None or Not Known The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 12 10. Are you a practicing attorney? ☒ Yes ☐ No ☐ Judicial Officer/State 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 2021. ☒ 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 Business/Commercial Litigation, Bankruptcy, and Education. 11. During 2021, 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 9 of 12 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. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) Colibri Group Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 2021, 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 10 of 12 15. During 2021, 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 2021 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 No Contributions The SEI and any attachments, excluding the Confidential Form, are public records. Page 11 of 12 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 so, 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 so, you must indicate whether during 2021 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 12 of 12 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 04/13/2022 Signature Date Augustus Melton Black JR Printed Name

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 11 STATE ETHICS COMMISSION 2021 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. Augustus Melton Black JR Current Employer Job Title Colibri Group & Of Counsel to Everett Gaskins Hancock LLP via A. Melton Black, Jr. Atty at Law, PA Educator and Attorney Nature or Type of Business Education and Law Reason For Filing (Complete all that apply.) 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.) Real Estate Commission Judicial Officer (Specify office.) Legislator (Specify House or Senate.) A. Do other immediate family members reside in your household? ☒ Yes ☐ No On this form, ”immediate family” includes your spouse (unless legally separated). 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 Andrew Melton Black Child BrightPath Education Services LLC Office Assistant Education Marion Tracy Black Child Brightpath Education Services LLC and College Work-Study Office Assistant and worker Education and College Work-Study The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 11 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, 2020, 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston Augustus Melton Black JR (Self) 100.00% Raleigh Wake 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 2019 or 2020, did you or any members of your immediate family sell to or buy from the State of North Carolina personal property worth $10,000 or more? ☐ 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 11 Financial Interests 3. As of December 31, 2020, 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 ►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 Augustus Melton Black JR (Self) BrightPath Education Services LLC Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) SouthCity Title Company LLC Augustus Melton Black JR (Self) Advance Title Company Augustus Melton Black JR (Self) AndMarb LLC 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 A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title Company LLC Title Insurance. Regulated by the State. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 11 4. As of December 31, 2020, 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 2021 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” https://ethics.nc.gov ☐ Yes ☒ No Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2020, 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. ☐ 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 2020. 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. Please remember to disclose your receipt of salary or wages from any governmental or private entity. Do not include income received from the following sources: ► Capital gains ► Federal government retirement ► Military retirement ► Social security income/SSDI Recipient of Income Name of Source Type of Business/Industry Type of Income Augustus Melton Black JR (Self) BrightPath Education Services LLC Education Other type of income Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income Augustus Melton Black JR (Self) Raleigh Regional Association of Realtors Education Professional fees The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 11 Professional and Civic Relationships 7(a). During 2020, 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. ► 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 2020, 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 because you are a legislator or judicial officer or you are filing as an appointee to one of 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 11 9(a). List the name of each business with which you were associated where you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2020. Name of Person Relationship to Filer Name of Company Role of Person Andrew Melton Black Child BrightPath Education Services LLC Employee Marion Tracy Black Child BrightPath Education Services LLC Employee Augustus Melton Black JR Self BrightPath Education Services LLC Manager Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self SouthCity Title LLC Partner Augustus Melton Black JR Self Advance Title Company Partner Augustus Melton Black JR Self AndMarb LLC Partner 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, 2020, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. AndMarb LLC None or Not Known BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title LLC Title Insurance. Regulated by the State. The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 11 10. Are you a practicing attorney? ☒ Yes ☐ No ☐ Judicial Officer/State 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 2020. ☒ 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 Business/Commercial Litigation, Bankruptcy, and Education. 11. During 2020, 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 Real Estate Appraiser Licensed Professional Real Estate Broker Licensed Professional The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 11 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 because you are a legislator or a judicial officer or you are filing as an appointee to one of those offices. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) BrightPath Education Services LLC Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 2020, 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 9 of 11 15. During 2020, 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 a judicial officer or you are filing as a judicial officer appointee. ► 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 2020 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 02/26/2020 $100.00 Roy Cooper (Governor) 06/29/2020 $100.00 Roy Cooper (Governor) 10/16/2020 $500.00 Roy Cooper (Governor) The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 11 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 so, 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 so, you must indicate whether during 2020 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 11 of 11 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 03/28/2021 Signature Date Augustus Melton Black JR Printed Name

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 11 STATE ETHICS COMMISSION 2020 STATEMENT OF ECONOMIC INTEREST This entire form must be completed to fulfill your ethics filing obligation. ____ Checked for completion ____Scanned ______Date Incomplete Qs ____ ____ ____ ____ Supp. sent date _______ by _____ Supp. received date _________ Entered in database ______ by ______ Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Mr. Augustus Melton Black JR Current Employer Job Title BrightPath Education Services LLC and Everett Gaskins Hancock LLP Educator and Attorney Nature or Type of Business Education and Law Reason For Filing (Complete all that apply.) 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.) Real Estate Commission Judicial Officer (Specify office.) Legislator (Specify House or Senate.) A. Do other immediate family members reside in your household? ☒ Yes ☐ No On this form, ”immediate family” includes your spouse (unless legally separated). 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 Andrew Melton Black Child BrightPath Education Services LLC Office Assistant Education Marion Tracy Black Child so.ca Restaurant and Brightpath Education Services LLC Hostess and Office Assistant Food/Drink and Education For Staff Use Only Date Received: The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 11 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, 2019, 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 Augustus Melton Black JR (Self) 100.00% Raleigh Wake Augustus Melton Black JR (Self) 100.00% Cherryville Gaston 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 2018 or 2019, did you or any members of your immediate family sell to or buy from the State of North Carolina personal property worth $10,000 or more? ☐ 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 11 Financial Interests 3. As of December 31, 2019, 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 ►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 Augustus Melton Black JR (Self) BrightPath Education Services LLC Augustus Melton Black JR (Self) A. Melton Black, Jr. Attorney at Law, PA Augustus Melton Black JR (Self) SouthCity Title Company LLC Augustus Melton Black JR (Self) Advance Title Company Augustus Melton Black JR (Self) AndMarb LLC 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 A. Melton Black, Jr. Attorney at Law, PA Practice of law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title Company LLC Title Insurance. Regulated by the State. The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 11 4. As of December 31, 2019, 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 2020 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” ☐ Yes ☒ No Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2019, 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. ☐ 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 2019. 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. Please remember to disclose your receipt of salary or wages from any governmental or private entity. Do not include income received from the following sources: ► Capital gains ► Federal government retirement ► Military retirement ► Social security income/SSDI Recipient of Income Name of Source Type of Business/Industry Type of Income Augustus Melton Black JR (Self) BrightPath Education Services LLC Education Other type of income Augustus Melton Black JR (Self) A. Melton Black Jr. Attorney at Law PA Law Other type of income Augustus Melton Black JR (Self) Rental of Real Property Rental of Real Property Rental income The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 11 Professional and Civic Relationships 7(a). During 2019, 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. ► 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 2019, 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 because you are a legislator or judicial officer or you are filing as an appointee to one of 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 11 9(a). List the name of each business with which you were associated where you or a member of your immediate family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2019. Name of Person Relationship to Filer Name of Company Role of Person Andrew Melton Black Child BrightPath Education Services LLC Employee Marion Tracy Black Child BrightPath Education Services LLC Employee Augustus Melton Black JR Self BrightPath Education Services LLC Manager Augustus Melton Black JR Self A. Melton Black, Jr. Attorney at Law PA Proprietor Augustus Melton Black JR Self SouthCity Title LLC Partner Augustus Melton Black JR Self Advance Title Company Partner Augustus Melton Black JR Self AndMarb LLC Partner 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, 2019, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State A. Melton Black, Jr. Attorney at Law PA Practice of Law. Regulated by the State. Advance Title Company Title Insurance. Regulated by the State. AndMarb LLC None or Not Known BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. BrightPath Education Services LLC Developing and offering educational curriculum designed for real estate appraisers and real estate brokers. Regulated by the State. SouthCity Title LLC Title Insurance. Regulated by the State. The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 11 10. Are you a practicing attorney? ☒ Yes ☐ No ☐ Judicial Officer/State 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 2019. ☒ 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 Business/Commercial Litigation, Bankruptcy, and Education. 11. During 2019, 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 Real Estate Appraiser Licensed Professional Real Estate Broker Licensed Professional The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 11 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 because you are a legislator or a judicial officer or you are filing as an appointee to one of those offices. Real Estate Commission Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) Augustus Melton Black JR (Self) BrightPath Education Services LLC Regulatory Augustus Melton Black JR (Self) Real Estate Broker License Licensing 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 2019, 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 9 of 11 15. During 2019, 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 a judicial officer or you are filing as a judicial officer appointee. ► 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 2019 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 06/12/2019 $100.00 Roy Cooper (Governor) 06/12/2019 $25.00 Roy Cooper (Governor) 09/26/2019 $2,000.00 Roy Cooper (Governor) The SEI and any attachments, excluding the Confidential Form, are public records. Page 10 of 11 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 so, 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 so, you must indicate whether during 2019 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 11 of 11 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 03/22/2020 Signature Date Augustus Melton Black JR Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

a or Sit se oie CEIVED Fr STATE ETHICS COMMISSION Dore Receved REC 8g CT 18 2018 Let 2019 STATEMENT OF ECONOMIC INTEREST = crea NGETHGREIMMISSION LFcamnes © Bare This entire form must be completed to fulfill Hmplete gs. i = your ethics filing obligation. Supp. sent date _ LE Supp. receed ame _ Fr — [Files Name (Fist, Middle, Last) Prefix | First Name Middle Name Last Name Suffix Me [Aucasrics |e crom Beseisc EA Current Employer Job Tie cat prt Lpuesrion Lee any Eepbrr EMswrrs Honcoen zen] Open [A = Nature or Type of Business I IP FE Eruct rm LA Reason for Filing (Complete all that apply.) Are you a CANDIDATE for elected office? [J] Yes [No | If yes, for what position are you seeking election? (Specify (Not including local or municipal office) Tomekerice shaking in box belowy Do you currently hold this position? Oves io | | State Government Jab (Speciy agency and postion) | Beard/ Commission (Lit fe complete names of al State | | boards on which you are serving or are being considered.) Por Estate CommasTon Judicial Officer (Specify office.) Legislator (Specify House or Senate) A. Do other immediate family members reside in your household? | wie On On ths form, “immediate family” includes your spouse (unless legally separated). It also includes members of your | extended family (your and your spouse's children, grandchilaren, parents, grandparents, and siblings, and the spouses | of ach of those persons) who reside in your household. | Mish iiibisdbbimdsi— List the full name of all adults and emancipated minors in your household. Minors are chidren under 15. They are emancipated by marriage, enlistment in the US miitary, o court order for emancipation Full names of Adults and | Relationship Employer Job Title Nature of Business | Emancipated Minors _ i ote Meron Bose Sor |Besealor |Pur.rene fssod Epucrrrm | | | BE J L . The SEI and any attachments, excluding the Confidential Form, are public records. Page 10f 10 [moe only the initia of ll anemancated minors in your household belo. A minor is chia under 18 years ol. | List the full name of each minor child on the Confidential Form at the end. | lnatset Relationship Employer JobTitle | Nature of Business | minors " rr rr =r 1] I A A | Property Interests. } 1. As of December 31, 2018, did yau or any members of your immediate family: | A. have an ners terest n North Carolin real estate (cluding your residence) with a market value of $10,00 | or more? | we One | Owner of Real Estate | % Ownership Interest | Location by City | Location by County | eo Bese PE co Bese Gorman I 1 [7 . tease or rent realestate o personal propery to or from the State of North Carolina with a market value of $10,000 or more? | Ove 6 | Name of Lessor | Name of Lessee If Real Estate, Location | If Personal Property, . | renee oveiyadomy | deserve EE SE EE [2 AC any time during 2017 or 2018, did you or any members of your immediate family sel to or buy from the State of | | North Carolina personal property worth $10,000 or more? | | oe Name of Purchaser | Name of Seller | Type of Property EE I SS | The SEI and any attachments, excluding the Confidential Form, are public records. Page 20f 10 Financial Interests ] [3 As of December 31, 2018, did you or any members of your immediate family own any of the following financial interests Vahued ax $10,000 o more Lis each company indridualy. | A. Stock in a publicly owned company? Ove fe > Do nat it interests in a willy held Investment fund (including mutual fonds, reguated vestment companies, or pension or defered compensation pane) 1. the fund i publicly traded or ts assets are widely diversified; and 2 nethr you no an imediat family member are bie 1 Corre he underlying assets. | I Owner of Interest CTT I EE — | B. Stock options in a company or business? | owe 9h I ‘Ouner of Stack Option Full Name of Company (Do not use a ticker symbol) [ C._ Interests n a non-public owned company or business entity? These include interests n se propretorships, arnershps, Iie parnersnps, Jom ventures, mite ably Companies, Wied 1401y paring and Gosel held corporations, Wes ONo- 1f"No,” proceed to question 4. | Owner of Interest Name of Company ar Business Entity TAT Bersih Ercorion Sree = Se ram 3 Aer net are and Met 3 Gorn Cxrr Titra Comm pay Lic AEC 73 Crt Commack [FTN en Bloc bre or CU1). For each company or business entity identified in question 3.C. the “Primary Company") please Ist he hames of any ather COMpaNIS or business entities in which the Primary Company owns SeCuIES of eau interest vad at over $10,000, known Non-Publicy Owned Company or Business Entity | Other Companies in which the Primary Company (the Primary Company) Owns Security or Equity Interests [one or not known The SEX and any attachments, excluding the Confidential Form, are public records. Page 301 10 I ————.—SSSBh C2). you know that any enti listed in 3.C or 3.C(1) above nas any material business dealings o business | Contracts with th State of North Carolina, o 15 regia by the Sate, briefly describe hat business acti: omer Company or business Enity | Description of Business Activity with th sate J None or Not Known | oY = “Reged Bozo lira & Don Serer ces de pba sre = Nines 4 fal(5 fale Co - yr) pero Buieie, Tp AIToANE r pr tint Pty = Loc Gest. crrr Terie Comyihoy, Cec pide | Tho dpi TTT Cpt | og PC tate Te Ese AE | 4. As of December 31, 2018, were you or any members of your immediate family the beneficiaries of a vested trust with 2 value of $10,000 or more hat you created, etabished, or controled? | Do not list assets held in blind trusts. See 2019 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” | | = | Name and Address of Trustee Description of the Trust Your Relationship to the Trust | 5. oof December 3, 2018, 0d you any members of your immediate family have lables of $10,000 or more, excluding the Mortgage on your pimary DeTSoRal rescence” Exampies Include red Car debts, auto ans, student oans, | personal loans and intra-family debt. | Ofes [Oho Name of Debtor Type of Creditor (commercial Bark, credit union, individual, etc.) « Reser Andomp te Coad ot Compan, EE [6 List each source of income (mat specific amounts) of more than $5,000 received by you or any members of your immediate famiy during, 3018. Inch say, wages, tat/local govemment retirement income, professional foes, | Ronorana, interes, diigends, rental Income. uses Income, and othe types redired 0 be reported on state and | federat ta reruns. Do met include income received from the folowing sources: | |» capital gains > Federal government retirement | |» vary retrement > Socal securty Income/ Sst | | Redpientof income Name of Source | Type of Tyrer Income | | BuEiness/tndustry Bl | [11 had no reportable income over $5,000 in 2018. | Ae Beer Basar ra __ Cotes Pramncees I 1 [Me Boe etobtense Mate Lin | stoes Drzucrns] « ip Diet Treaster | Rent Bl CT Geir 235 prs pm | Ror ium rrr Cotecation bail The SEE and any attachments, excluding the Confidential Form, are public records. Page 4of 10 pressions and Civic Relationships oo EE — Noth Caroma many vor vlgious, charaamir seni, Revi PA. meat ‘at eo Easton > Do mt et Sate Beards o ame, Name of Person Name of Nonprofit Nature or | on | Purses dararisaon — [ | [ [ [ | 700. I nonprofit corporations o organizatens sted above do business wih the Ste of forth Corl a rece Se a En a eer oe on | | Name of Nonprait Corporation or Organization | beserbe sate usiness | Otfene or Not Known 1 [—————————————————————————————————————————————eeeeeee | I T 1 | | | _—lt 7 1 | | 18. During 2018, 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 [A [ives fo ClLepatorusiiat afte ou a nt request complet thi question you sre Ring bagouse |» Donotlist ‘organizations of which you are only a member and do not serve in a leadership role. TTT Name of Society, Organization, Leadership positon or Savors Goon (Director, orice, Board Member) —— 1] I 1] | I I I] The SEL and any attachments, excluding the Confidential Form, are public records. Page sof 10 (a), List the name of each business with which you were associated where you or a member of your immediate family | was an employee, drector, office, partner, proprietor, of member or manager ot of December 31, 2015. { Name of Person Relationship to Filer Name of Company Role of Person 010 Business Associations lee Peser Frien Levin! Lo OfFee [Mme a y Bact cent earn Busen Tn Minty 0 [fea [shpat or Rnee See on Seip Cer TIE i a8 2 [7 Jlatic ric 9 ton nr aca fst Gt Lobia 5(b). If you know that any enty listed n 5(a) above had any material business dealings or business contracts wih the State of North Carolina or was reguiated by the State a5 of December 31, 2018, piel describe that sctity Cot apphcable (No entities sted on #3) = Ce — Bop eellns Evscerzan |b atte = Appogs ed exiide ctl I Leo A Mem pi Biren TA Arras, ing flo smile TL, RE Tri Compan ry = [Sense re at 30. ve you a practicing attorney? | mE OMe dal offcerstate Attome | ves", check each category of legal representation in which you o the law firm with which you ae afiated has eared legal fees of more than $10,000 during 2015. | pamnsirtne Admiralty. Corporate Ocriminal | Decedent's Estates (J Environmental insurance 0 tabor | [Local Government [Real Property [J securities. OTax | OTort ination (including 0 Unites Reguiation £1 0ther category not sted negligence) 11. During 2018, were you 3 lensed professional (other than an attormey) or did you provide consuling services | Individually or 25 a member of professional association for which you charged or were paid ver $10,003 | ee On Type of Business. Nature of Services Rendered Res sre Bro Lrcerser (Rebessmmne Res Citar Apppoesen License PiFenpomsc The SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. Are you o your employe, o any members of your immediate family, or their employers currently. ] + Wcensed by the State boar or agency with which you are o wil be associated or | + regulated by the State board or agency with which you are or will be associated or | + ipbusinss relationship with the State board or agency ith which you are or wil be associated? | we [No [J Legistator/Judicial Officer - You are not required to complete this question f you are filing because | Vou are 3 Ieqlator or dict oer or You 316 0G 55 an ApPOITEE 0 One of hose OES. | Name of Person ame ot plover | Type of Relationship (if applicable) | (Licensing, Regulatory, Business) | ce < in Gime Beaten | Lrcenstoc | o% [Mer Burere | Brrewlin fpr) Recourse | SE NE — 15. Wave you or 2 mares of your Immediate family been egetared a5 a 1oWoyt or lbynt pvioal wi the 12 | months Brecedingorour fing of the forms Eves oe | TT Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration ] | Other Disclosures 14. During 2018, after you were aopoitad, employed, o ied or were mominated 2 canis, 4a 703 | + receve any "aisy" exceeding $200 per auarter fom a perso or group of persons acting together, | + when both you and hose personts) were outside North Carolina, | + under circumstances tht woud ead a reasonable person to conclude the is were given for abbying? | To answer Yes, all three conditions must apply. | |» 00 nt rept gifs iv by members of your extended fami. » Do not report its you have previously reported on the "Expense Report for Exempted Persons.” [oat tem Recued | ame an dares of anor) | Describe Hem Received | Estimated Market | Value | | — The SEE and any attachments, excluding the Confidential Form, are public records. Page 701 10 [15 rn 2080. vows poses mors, fer wr rts rons, 9570 | | + accept a “scholarship” exceeding $200 related to your public position from a person or group of persons acting | |" togetner, | | + when those person(s were outside North Carolina? | To answer Ys, both conditions mst appy. | A*scholrsni” is gant n-ie either direct or indirect, sttend conference, meeting, or siilar event, | Inching Fag rowel Fading, meal, and other siIar Expenses: | Oves eo Judicial Office - You are not required to complete this question if you are a Judicial officer o you | aren 25a ah! ofees appomtee |» Do not report ais you nave previousy reported on the “Expense Report for Exempted Persons.” > Legsators are nt required o report scholarships paid by nonpartisan legislative organization of which the fgisitor | tne General sasemty 2 members partcpants of atiate Date of Name and Address of Donor(s) Describe Event. Estimated Market schataronip Vowe | | 6. Hove vou beer, apponted o comsdered for ppamment o 3 covered board by the Governor or another Col a | Shoe members | Council of State members are: | » Governor > Lt Governor > Secretary of State | » State Autor » state Treasurer » Superintendent of Public Instruction > Attomey Genera » Commissioner of Agriculture» Commissioner of Lab Commissioner of nurancs Tr De Garni 1 "Ves, lst al contributions you made in 2018 with a cumulative total of more than $1,000 to the Council of State member whe appointed you. 96 not clude contributions rom immediate faminy members. » Contributions are defined broadly n N.C. § 163A-L411(13) and include “any advance, conveyance, depos, Garnooton, anes of ane, oan, PORE, G1, pledge o Sbtrguen of mone or aang of his whetsomver vate Amount Contributed to Re conibaonts) wih a cumulative toa of more han $1,000 S— — 1 I} | The SEE and any attachments, excluding the Confidential Form, are public records. Page sor 10 17. ve you an appointee o prospective appointee a5 ] a. the head of a principal sate department (e.g. cabinet secretary) appointed T the Governor; or | 5. a North Carolina Supreme Court Justice, Court of Appeal, Superior or District | | Court dodge or | | member of any of the following boards: Oves ©Ne + ABC Commission IF "No," proceed to question 15 + Const 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 | | | + Gow of Transportation | | + ties commission 1 + Wildiife Resources Commission d. If s0, were you appointed or are you being considered for appointment to that | [J Yes []No. | position by » Council of State member? re Ta 1 as ©. If s0, you must indicate whether during 2018 you engaged n any of the | | following activities wih respect to or on behalf of the candidate or Campion | committee of the Council of State member who appointed you: | | i. Collected contributions from multpie contributors, took possession of such multiple contributions, and transferred or delivered those collected | [Yes [No Contributions to the candidate or committee? i Hosted a fundraiser at your residence or place of business? EE iii. Volunteered for campaign-related activities, including phone banks, event | } assistance, mailings, canvassing, surveying, or any other actly thet | Ces [No advances fhe campaion of a candidate” | 718. Have you ever been convicted o a felony for which you have not received ene: (1) & pardon; or (1) an order of Expungement? Oves oy 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 ] | Conceming your compliance with the State Government Ethics Ac | | Ove og yes, piease provide that information below | - The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 Affirmation 1] The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate | | 1 have read and understand the following statutes: | A filing person who provides false information on a statement of economic interest . . . knowing that the | | SZ PL Coser [7,219 Signature Bate | ice ( « | Submit signed, original documents ony. Da nat ax or e-mail this form. | memes | iii