Barbara Campbell Davis
Edgecombe Community College Trustees
Filings
2026 Edgecombe Community College Trustees
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2026 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM
ELECTRONIC FILING
This entire form must be completed to fulfill your
ethics filing obligation.
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Barbara Campbell Davis
Reason for Filing (Complete all that apply.)
Are you a CANDIDATE for elected office? ☐ Yes ☒ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this position? ☐ Yes ☐ No
State Government Job or Post-Service Filer (Specify
agency and position.)
Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Edgecombe Community College Trustees
Judicial Officer, Post-Service Filer, or Appointee (Specify
office)
Legislator, Post-Service Filer, or Appointee (House or
Senate)
This entire document is a public record.
AFFIRMATION
I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue
to be true, correct, and complete to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my No Change Form is a public record.
I have read and understand the following statutes:
N.C.G.S. § 138A-26. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed
on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary
action under G.S. 138A-45.
N.C.G.S. § 138A-27. Penalty for false information.
A filing person who provides false information on a statement of economic interest . . . knowing that the
information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 01/12/2026
Signature Date
Barbara Campbell Davis
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2025 Edgecombe Community College Trustees
Document text
This entire document is a public record.
STATE ETHICS COMMISSION
2025 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM
ELECTRONIC FILING
This entire form must be completed to fulfill your
ethics filing obligation.
Filer’s Name (First, Middle, Last)
Prefix First Name Middle Name Last Name Suffix
Ms. Barbara Campbell Davis
Reason for Filing (Complete all that apply.)
Are you a CANDIDATE for elected office? ☐ Yes ☒ No If yes, for what position are you seeking election? (Specify
name of office seeking in box below.)
Do you currently hold this position? ☐ Yes ☐ No
State Government Job or Post-Service Filer (Specify
agency and position.)
Board/Commission (List the complete names of all State
boards on which you are serving or are being considered.)
Edgecombe Community College Trustees
Judicial Officer, Post-Service Filer, or Appointee (Specify
office)
Legislator, Post-Service Filer, or Appointee (House or
Senate)
This entire document is a public record.
AFFIRMATION
I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue
to be true, correct, and complete to the best of my knowledge and belief.
I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from
disclosure while retaining an equitable interest.
I understand that my No Change Form is a public record.
I have read and understand the following statutes:
N.C.G.S. § 138A-26. Concealing or failing to disclose material information.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed
on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary
action under G.S. 138A-45.
N.C.G.S. § 138A-27. Penalty for false information.
A filing person who provides false information on a statement of economic interest . . . knowing that the
information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45.
I affirm under penalty of perjury that the foregoing is true and correct.
Filed Electronically 03/12/2025
Signature Date
Barbara Campbell Davis
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
2024 Edgecombe Community College Trustees
Document text
FOR STAFF USE ONLY
ZEN STATE ETHICS COMMISSION Date Received:
A
0] 2024 STATEMENT OF ECONOMIC INTEREST RECEIVED
7 No Change Form AR 20 20
This entire form must be completed to fulfill
Your SEI filing obligation. NC ETHICS COMMISSION
Filer’ Name (ist, middle, Lost
[prefix | FirstName | wiadiename | uasthome | sux
[Bowvona Soe
Reason for Filing (Complete al that apply.)
State Government 105 (Speci agency and postion.) | Board/Commission (List the complete names of ll State
boards on which you are serving or re being considered.)
foe Comb Communi Cote
I B74 1c ¥ s
Carvery Serving 2% 3 Judeal Officer (Speci office.) | Currently Serving as 3 Leoator (Speci House or Senate)
‘Are you a CANDIDATE fo a covered elected ofice? | 11 yes, specify office and Gstrct/county If applicable:
(District, Supreme, or Superior Court; Court of Appeals;
Clerk of Court; DA; Legsiator; Member, Counci of tate)
Oves Eto
AFFIRMATION
have carefully reviewed my mest recently fled Statement of Economic Interest Long Form and my responses continue
tobe true, corect, and complete to the best of my knowledge and belt.
1 have not transferred, and wil no transfer, any asse, interest, o property for the purpose of concealing It from
disclosure whi retaining an equitable Interest
Tunderstand that my No Change Form is public record.
Ihave read and understand the following statutes:
N.C.G.5. § 1384-26. Concealing or failing to disclose material information.
A fling person who knowingly conceals or knowingly fall o disclose information tha i required to be disclosed
on a statement of economic Interest .. shal be Quit of a Cass 1 misdemeanor and. - subject to disciplinary
action under G.5. 136-45.
N.C.G.S. § 1384-27. Penalty for flse information.
A fling person who provides false information on a statement of economic terest... knowing that the
information is folse is uity of a Cass H felony and shal be subject to disciplinary action under G.5. 138A-45.
Taffiem under penalty of perjury that the foregoing is true and correct.
Rode Coie. © ot 2/1 [~n4
Signature ate
Bow sonar Camploe\\ Danis,
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form.
This document is a public record.
2023 Edgecombe Community College Trustees
Document text
a. FOR STR TSE GY
GTR STATE ETHICS COMMISSION Ost Received
(a 2) 2023 STATEMENT OF ECONOMIC INTEREST REGEWVED
= No Change Form AR 27 2023
This entire form must be completed to fulfill NC ETHIGS COMMISSION
Your SEI filing obligation. pS
| [Soreoe [Congo | Onis ||
Reason for Filing (Complete all that apply.)
State Government Job (Speci agency and poston) | Boord/Commisen (Ls ie compere names ofa Ste
Boards on which you ae seing o oe being consiered
Tdogconte Coveunsdy| (ol
I | Ra
Currently Serving or Served as a Judicial Officer in 2022 | Currently Serving or Served as a Legislator in 2022 (Specify
(Spey ofc, .9. ude, der of cor, Bick sioner.) Howse of Senate)
APFIRAATION
have careful reviewed my most recently fled Statement of Economic Interest Long Form and my responses continue
1 tre, corec, and complete t th best of oy Knowiedpe and bet
Lhave not transferred, and ill no transfer, any asset Interest, o property or th purpose of concealing i from
islosur whl retaining n equtable meres.
understand that my No Change Form sa puble record.
have read and understand th follwing satus:
NC.GS. § 1384-25. Conceling or filing to discass material information.
A fing person who knowingly conceals or knowingly fais o disclose information that Is required to be discased
an a Statement of aconamic Interest hal be Quy of 3 Cass 1 Msdemeaner and « object 1 ahepionny
Seton under G5. 156-45.
NC.GS. § 1398-27. Penahy for fale formation.
A fling person who provides fs information an statement of economic terest. knowing tha the
information ase 1 uly f 8 Cass felony and shall be Suofect o G4ciinary Scion uncer Go, 3304-45.
affirm under penalty of perjury that the foregoing is true and correct,
;
Bana Coton Dg 26love
Signature Date
Bowsower Complaaih Davis
Printed Rame
Submit signed, original documents only. Do not ax or ¢-mall this form.
This document is a public record.
2022 Edgecombe Community College Trustees
Document text
a
FE STATE ETHICS COMMISSION Sate caved:
{AME58 2022 sTaTEMENT OF ECONOMIC INTEREST _
tal gl) ER HEGEIVED
= No Change Form N
FEB 07 200
This entire form must be completed to fulfill
your SEI filing obligation. NG ETHICS COMMISSION
fp ——————
ers Name (Fist, Middle, Las)
[Prem | rirstName | middie Name | Last Name [ sutrix_|
I [Bowbava [Caml Dans I]
Reason for Fling (Complete all that apr) I
‘State Government Job (Specify agency and position.) ‘Board/Commission (List the complete names of all State
Doar an whieh you ar serving o ae peing gonggere.
‘Currently Serving as Judical Officer (Specify office.) _| Currently Serving as a Legisetor (Specify House or Senate.)
re You s CANDIDATE for 3 covered lected office? | | 1 Ves, specy affce and Distr County , applica:
(District, Superior, o Supreme Court, Court of
Clerk of Court, District Attorney, General Assembly)
Oves_[iNo
AFFIRMATION
have carefully reviewed my most recently led Statement of Economic Interest Long Form and my responses continue
be re, Correct, and complet t th est of my Knowledge and pele!
have not translerred, and wil not transer, any asse, interest, or property fo th purpose of concealing I fom
iscosure while retaining an equiabe terest
understand tha my No Change Form i » public record.
have read and understand the folowing statutes:
N.C.6.5. § 1384-26. Concealing or falling to disclose materll Information.
A fling person who knowingly concess o knowingly al to disclose nformatio tht s recur t be disclosed
ons Steet O SCONOTIC MHGTest «hall 6 July Of Gigs 1 Misdemeanor and unit 1 docipmary
Scion under G.5. 1398.45.
N.C..5. § 138A-27. Penaty for false Information.
A fling person who provides fls Information on a statement of economic terest... knowing that he
Information alse fo guy of a lass eony and shall be subject 1 Gscipinary action under 6.5. 1364-45
Taffirm under penalty of perjury that the foregoing Is true and correct.
Boren Coron Don | /20/a0m
Sanaure Bate
Bamana Canvplooh Danis
Printed ame
Submit signed, orginal documents ony Do not fax or e-mail this form.
This document is a public record
2021 Edgecombe Community College Trustees
Document text
For stat Use Only
POZERN STATE ETHICS COMMISSION —_—
EF 2021 STATEMENT OF ECONOMIC INTEREST |
NE NO CHANGE FORM RECEIVED |
This entire form must be completed to fulfill | FEB 09 2021
your SEI filing obligation.
| NeemHics commission
rr a — EE —
[prefix FirstName | Middle Name Last Name. T sux |
hy Bowbower | Carvghae th DANS |
Reason for Fling (Complete all tat apply.)
Sane Government Job (Specty sgency and postion.) Board/Commisson (Lat the complete names of al State _
| } 03rd on which you are serving or are being corsicered.)
Ege. Lotti Tole
B RodvA of Tvustees
Jucicial Officer (Specify office.) Legislator (Specify House or Senate.) |
|
1 have carefully rev eve my mest recently fied Statement of Ecenomic Interest Long Form enc my responses continue
| to be true, correct, and camplete to the test of my knowledge and belief.
Inve not transferred, and wil nx transfer, any asse, itarest, or progety for tne purpose of concealing it from
disclosure while retaining an equitable interest
1 uncerstand that my No Chenge Form is a pubic record,
Ihave read ang understand the following statutes:
N.C.G.S. § 1384-26. Concealing or failing te disclose materia! information
| Afiling person who knowingly conceals er knowingly fails to disclose Information that Is required to be disclesee |
on a statement of economic Interest. . shal 5¢ Guiky of & less 1 mseemeanar arc . - subjec: to disaplnary
action uncer G.5. 1383.45
| N.C.G.S. § 17RA-27. Penalty for false information.
A fling person sno orcvices fase Information on a statement of economic Interest... knowing that the
format on is f58 4 gulty cf Cass H felony 3n¢ shall ba Subject 10 disci rary Acton undo: G.5. 138-45.
1 affirm under penalty of perjury that the foregoing is true and correct. |
|
Garde Coram BD gor NN BAW RYN
Signature Date
|
| Barleava Campleel Davie |
Printed Name
Submit signed, original documents only. Do not fax or e-mail this form. oo
This entire document is a public record.
2020 Edgecombe Community College Trustees
Document text
oi a—
NY . — Sate Recees
ZEN STATE ETHICS COMMISSION ELCEVED
c4 Ji] 2020 STATEMENT OF ECONOMIC INTEREST -
? NO CHANGE FORM | MAR 202
This entire form must be completed to fulfill | ovis COMMISSION
your SEI filing obligation. | Checked for completion
[seomes ome |
| nereainon oy |
Filer's Name (First, Middle, Last)
| Prefix First Name | Middle Name Last Name Suffix |
[ [Tome [Bvoww | Sans |
Reason for Filing (Complete all that apply.)
State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State
Boards on whch you are serving or are being tons geri.)
Edac co OM Mw oltea
RB of Trustees
Judicial Officer (Spec office.) Cegisiator (Specify House or Senate.)
AFFIRMATION - ie a — ——
have carefully reviewed my mast recently fled Statement of Economic Interest Long Form and my responses continue |
0 be true, correct, and complete to the best of my knowledge and peel |
have not transfered, and wil no transfer, any asst, interes, or property for the purpose of concealing t from |
disclosure whi retaining an equkable merest |
understand that my No Change Form is a public record
1 have read and understand th following statutes:
| NCS. § 138A-26. Conceaing or falling to disclose material information
A fing person who knowingly conceals or knowingly fis to disclose information that is required to be disclosed
on a Statement of economic Inerest shall be GUIY of a Class 1 misdemeansr ond subject to Secsmny
Seton under G.5, 138A-45.
N.C.G:S. § 138A-27. Penalty for flse information
A filng person who provides fais information on statement of economic interest... knowing thet the
information fase 1s guity ofa Cass felony and shal be Subject to iciplinary action under G.0. 1364-45
1 affirm under penaity of perjury that the foregoing is true and correct. |
A 2 [na [3030
ators : Bate
| doc BR, Dpurs
Printed Name J
Submit signed, original documents only. Do not fax or e-mail this form. B
This entire document s a public record.
2019 Edgecombe Community College Trustees
Document text
. TN For starr Use onAN v
Farad STATE ETHICS COMMISSION ove recames
A i 7 STATE ETHICS COMMISSION
GLU; 2019 STATEMENT OF ECONOMIC INTEREST
NO-CHANGE FORM checked for completion S15
| hl
This entire form must be completed to fulfill your scomea _£1¢ pate 211111
ethics filing obligation. EE roe
Filer’ Name (First, Middle, Last) oi = ]
pre | Firstname | middie Name Lastname Sut
ova [Camploah Oawis |
Reason for Fiing (Complete al that apply.)
State Government Job (Specty agency and positon.) Board/Commission (List the complete names of al State
— boards on which you are serving or are being considered.)
Blyconbe Covpaniy Colledge
a oAvel of Testes 2
Judicial Officer (Specify office. Legisiator (Specify House or Senate.) |
AFFIRMATION - ee
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate to
the best of my knowledge and belie,
Ihave not transferred, and wil not transfer, any asset, interes, or property for the purpose of concealing It from disclosure
while retaining an equitable interes.
1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipted Children publc records.
Ihave read and understand the following statutes:
N.C.G.5. § 1634-191. Concealing or fang to disclose material information.
A fling person who knowingly conceals or knowingly fait to disclose Information tht is required to be disclosed on
2 statement of economic interest... shal be Quilty of a Class 1 misdemeanor and . . . subect to disciplinary action
Under G5. 1637-415
N.C.G.S. § 1634-192. Penalty for alse information.
A fing person who provides false information an a statement of economic interest... knowing that the Information
{5 false 1s uly of 3 Cass 1 felony and shal be subject to disciplinary action under G.5. 1634-415. |
L affirm that I have reviewed my most recently fled 2018 Statement of Economic Interest and that as of
December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and
belief.
Taffirm under penalty of perjury that the foregoing is true and correct.
Basare Copan Dns hala
Signature Bate |
DARsaen CAMPBELL DAV;
Printed Name
Dd Nome, cigns documents ony. Dorotaxoremmthistorm, |
This entire document is a public record.
2018 Edgecombe Community College Trustees
Document text
.;%. NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY
ZR}: ELECTIONS AND ETHICS ENFORCEMENT ate Received:
\"@/ 2018 STATEMENT OF ECONOMIC INTEREST
| 1
519-814-3600 [rep———— LY
Cetack tor compton
THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL sand aS one
YOUR SEI FILING OBLIGATION Incompiete % , o h
Sup. SentOme ny
Supp. Received Dots ___
Entered in database ay
FILER'S NAME (FIRST, MIDDLE, LAST)
First Name Middle Name | Last Name. B Suffix
IMs [Berbove [Comper [DAVES }
‘CURRENT EMPLOYER J08 TITLE
e¥ivey -—
NATURE OR TYPE OF BUSINESS
REASON FOR FILING (COMPLETE ALL THAT APPLY)
| STATE GOVERNMENT 108 (Specify Agency and Position) | BOARD/COMMISSION (List complete name of all State
A boards on which you are serving or are being considered
| oo Ed decor Colm nko Hoyo BA Thits
| JUDICIAL OFFICER (Speciy Office) | LEGISLATOR (specify House or Senate)
A. Do other immediate family members reside In your household?
Oves ino
When usd throughout this form, the term Immediate family includes your spouse (unless legally separated). It also
includes members of your extended far (your and your spouses children, grandchicren, parents, grandparents, and
siblings, and the spouses of each of those persons) who reside in your household.
List th full name of all adults ard emancipated minors in your household. A minor a hid under 18 years od.
Minors are emancipated by marriage, enlistment in the US miltry, or court oder for emancipation.
FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER 08 TITLE NATURE OF
EMANCIPATED MINORS. = ~ ‘BUSINESS
SA - SE
‘The SEX and any attachments, excluding the Confidential Form, are public records. Page1of 10
| [oUt ONLY the inti of a snemancsted minors n you hovschod below. A inr 3 id under 18 years 94.
| Note: You must is the ful name of cach minor chid on the Confidential Form available st the
|__end of this document. N
INITIALS FOR | RELATIONSHIP EMPLOYER Josie NATURE OF
| uNEMANGIPATED ‘BUSINESS
MINORS
| PROPERTY INTERESTS
1. As of December 21, 2017, dd you, your spose, or members of your mediate ory: =
A. Have an ownership interest in North Carolina rea esate (Including your residence) with a market vale of
$10,000 or more?
ves Ono
| Owner of Real Estate| % Ownership Interest | Location by ity Location by County
— ea Toders NC __Fdqecorhe
— ——_—_ CE WA ——. N——
8. Lease or rent rea estate or personal property tof from the State of North Carling witha market valoe of
$10,000 or more?
Oves Yine
Name of Lessor _ Name of Lessee | 1f Real Estate Location | If Personal Property,
“ Renter by City & County Describe
2. At any time during 2016 or 2017, did you, your spouse, or members of your immediate fami Sell to or buy fram the
State of North Carolina personal property with a marke val of $10,000 or mores
Ove fne |
‘Name of Purchaser ‘Name of Seer Type of Property
The SE and any attachments, excluding the Confidential Form, are public records. Page20f10
/
FINANCIAL INTERESTS
3. As of December 31, 2017, did you, your spouse, or members of your immediate family own any of the following financial
| interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY,
| A. Steck in a publicly owned company?
a
Do not list ownership interests in a widely held Investment fund (including mutual funds, regulated investment
companies, o pension or deferred compensation plane) if: () the fund = publ Taded or 1S asses are wiley
diversified; and (i) neither you nor an immediate family member are able to control the assets held in the mutual fund,
investment company, or pension or deferred compensation pan:
Owner of Interest Full Name of Company (Do not use a ticker symbol)
— ————— —_—t A
FERN RUUUT WA
8. Stack Options in a company or business?
Oves ano
Owner of Stock Option Full Name of Company (Do not use a ticker symbol)
. Interests. na non-public owned company or business entity (including interests in sol propietorships,
partnerships, limited partnerships, Joint ventures, limited labity compenies, Imited lab partnerships, and
closely held corporations)?
OYes lo iho” proce to ueston 4
Owner of Interest _ Name of Company or Business Entity
- —
I (1). For each non-oublicly own company or business entity (the primary company”) identified In question
S.C. above, please Ist the names of any other companies of siness entes in whieh the primary company
owns securities or eau interests valued ot over $10,000, # Known:
"Non-Publicly Owned Company or Business Entity | _ Other Companies in which the Primary Company
(the Primary Company) " ‘Owns Security or Equity Interests
None or Not Known
The SET and any attachments, excluding the Confidential Form, are public records. Page 30f 10
/
€ (2) 1F you know that any company or business entity sted n 3.C or 3.C(1) above has any material business
Gedings or Business convact with ihe Stat of Nh Carlin, or 1 eguB(ed by the See pr » one
description of tht business act. rn Corot !
Name of Company or Business Entity | Description of Business Activity with the State
None or ot Known ~ - —
4. As of December 31. 2017, were you, your spouse, or members of your knmadiata family the beneficiaries of vested
US witha vale of $10,005 o or tht was rote, CHAIRS, or artes By yooh
Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.”
Oves Jno
Nome and Address of Trustee Description of the Trust Your Relationship tothe Trust
5. As of December 31, 2017, did you, your spouse, or members of your Immediate fom have abies of $10,000 or
more, excluding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student
Taare, personal loans and me fob Gee
~ves [Ono
‘Name of Debtor (You, Spouse, Immediate Family Type of Creditor (Commercial Bank, Credit Union,
armory Snanidunt ete)
6. List each source of income (not specific amounts) of mars han $5,000 received by you, your spouse, or members of
your immediate famiy during 2017. Include. siry, wages, Satlcal government redrement, pioessonal Toco
Ronoroi, Interest, hens, real come, Busnes tore, ard ocr ype of orn fears ws D6 reported on past
State and federal tx etme
D0 nat Incude income received from the following sources:
| » Capital gains » Federal government retirement
> Miltary retirement > Social security income/ S501 B
Recipient of Income Nome of Source Type of Type of tncome
| suseemausy | TTT
31 hod no reportable income ver $5,000 m 2017.
Barbar Corphelt[reshter; Lhustnop Choon Pengo {
The SEX and any attachments, excluding the Confidential Form, are public records. Page aor 10
| PROFESSIONAL AND CIVIC RELATIONSHIPS
(a). During 2017, were you, your spouse or members of your immediate family a director, officer, governing board
member, employee, independert contractor, or registered lobbyist of 3 NOnBroft Corporation of orgeneaton opiates
the Sta of North Carolina primariy fo relous, chorkable, scentic, Ierary, PUBIC. health and ste, or <aucaara)
purposes?
| Ove io proces to mtn.
Do nk st State boards o entities, or enies created by 3 potcal subdion of th Sate.
> Do not lst organizations of which you are 2 mere member. ]
Name of Person His Her Position Name of Nonprofit Nature of Business or
" Corporation or Organization | Purpose of Organization
| 700)” if the nonprofit corporation or organization sted above do business with he State of North Carolina o receive
State funds, please provide 3 brief description ofthe nature of ha business, if Known with Which oe Sacnch souk
reasonably be known.
Name of Nonprofit Corporation or Organization Describe State Business or Stats Funding
tone or ot known
" During 2017 Were Vol, your spouse, or mbes of your Immediate fay a director, ofcer, 3 governing board |
member of any Society, organization, or advocacy Group with an merest in matters over which your 39arty or Bourd by
| Rave surdictont
|
| Oves Pho [Leisiatornudicial Officer - You are not required to compete this question if you are fing because
You are a legislator or a judicial officer or you are filing as an appointee to those offices.
Do not lst organizations of which you are nly a member (no serving in leadership ole).
Name of Person Name of Society, Organization Leadership Position
or Advocacy Group (Director, Office, Board Member)
I SE .
The SEL and any attachments, excluding the Confidential Form, are public records. Pages of 10
900. Lt the name of each company or business wih which you wre sscocted wher you ora member of your medte
family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2017.
Name of Person Relationship to Filer Name of Company | Role of Person
[Po ousines Associations
205). I you know that any comany or busines ent sted n (a) above had any mater business deaings
business contracts with the State of North Carolina or was regulated by the State as of December 31, 2017, provide a
rie dscrpion of hat business aii. reouieany oe
Name of Company or Business Entity Description of Business Activity with the State
Not applicable (No entities ted on #98)
| 10. Are you a practicing attomey? i
Dives XNo Cl udical OffcersSate Attorney
16Yes", check cach categary of legal representation n wich you orth lw firm with which you ae aflated hs cared
legal fees of more than $10,000 during 2017.
Administrative. 0 Admiralty (J Corporate: J Criminal
Decedent's Estates Cenvronmerta Olinsurance Cltabor
tocol Government Rent property secures am
[J Tort litigation (including 0 utilities Regulation (CJ Other category not listed.
negligence)
£1. During 2017.wee You a Ikensed professional (other than an attomey) or did ya provid consaing Serves
Iniidualy or a5 3 member of a professions sociation for Wh 703 charged o wes po or am
Ove ¥avo
Type of Business Nature of Services Rendered
EE Sr rr————
The SEX and any attachments, excluding the Confidential Form, are public records. Poge sor 10
12. Are you or your employer, your spouse or members of your immediate family, or their employer currently:
* Licensed by the State board or employing entity with which you are or will be associated or
~ Reculatd by th State board or employing entity with which you ar or wil be assodated or
* Have 2 business relationship with the State board or employing entity with which you are or will be associated?
C3¥es JRNo. []Legilatorudical Officer - You are not required to complete this question if you are ling because
You are a egsator or a udial aficer (dicil office” fs defined n the SE Helpful Tse) or you
are fing 3 an appointee to those offices.
Name of Person Name of Employer Type of Relationship
(i applicable) (Licensing, Regulatory, Business)
13.31 you, your spouse or a member of your mmedite fal current retard oa abby o abbyist prin, of
were you registered as such within the 12 months preceding your filing of this form?
Oves vo |
Name of Lobbyist Lobbyists Principal Date of Registration
Registration | Expiration
OTHER DISCLOSURES i} _
14. During any calendar quarter in 2017 (bu nly the time period after you were appointed, employed or fled or were
nominated 2 » candidat), i you
+ receive any "R(s)”excaeding $200 per quarter from a person o group of persons acting together, and
{= when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and
* the Gif(s) were given under circumstances that would lead reasonable person to conclude that they were given
for lobbying?
Oves Jno
D0 a report is given by members of your extended family.
00 not report gifs that have previously been reported by you t the Department of the Secretary of State on the
rss Report or Exempted Persons.”
ste tem Received | Ware and Adres of Dons) | Describe om Received | Estimated trker
Value
The SEI and any attachments, excluding the Confidential Form, are public records. Page7 of 10
75. During 7017 (but oy the time period after you were appointed, employed, or fled or were nominated as 2 candidate)
did you
| accept a “scholarship” exceeding $200 from a persan or group of persons acting together and
+ those person(s) were outside North Caroina and
« the scholarship was related to your public positon? A “Scholarship” is a grant-in-aid, either direct or indirect,
Yo sitend a conference, meeting, or similar event, induding tuition, travel, lodging, meals, and other
| similar expenses.
ves Foto [0 udicial Officer - You are not required to complete this question if you are a judicial officer or you are
ing as a judicial officer appointee.
| Do not report ifs that have previously been reported by you to the Department of the Secretary of tate on the
| “Expense Report or Exempted persons.”
» Legisators are not required to report scholarships paid by 2 nonpartisan legsiatve organization of which the egisiator
or the General Assembly is & member or participant o an affate of tha organization.
™ oateor ‘Name and Address of Donor(s) ‘Describe Event Eetimatod Market
Scholarship Value
16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or another
Counc of State member?
Council of State members are:
> Govemor » Lt. Governor » Secretary of state
» State Auditor > State Treasurer > Superintendent of Public Instruction
| > Attomey General » Commissioner of Agriculture > Commissioner of Labor
| > Commissioner of Insurance
Oves Jano |
11 “Yes? lit all contributions you (NOT immediate family members) made during 2017 with a cumulative
total of more than $1,000 to the Governor or other Council of State member who appointed You.
— are defined in N.C.G:S. 163-278.6(6) and include, but are nt limited to, "any advance, conveyance,
| Gepost, distribution, transfer of funds, loan, payment, Gif, pledge or subscription of money or anihing.of value
| whatsoever.”
Date i} Amount Contributed to
TJ No contrbution(s) with a cumulative total of more than $1,000
The SET and any attachments, excluding the Confidential Form, are public records. Pages of 10
17. Ae you an appointee of prospective appoint 5: TT
a. the head of a principal state department (e.5. cabinet secretary) appointed by the
Govemors or
5. 2 Noth Carolina Supreme Court Justice, Court of Appeal, Superior ar District
Court Judge: or
. a member of any ofthe folowing boards:
+ ABC Commsion
+ Coastal Resources Commission
+ State Board of Education Oves Xo
+ State Boar of Elections
Divison of Employment Securty I No proceed to
+ Environmental Management Commission Question 18.
© Industrial Commision
© Human Resources Commission
© Rules Review Commission
© Board of Transportation
+ UNC Board of Governors
* Utities Commission
+ Wife Resources Commision a
4. If s0, were you appainted or are you being considered for appontment to tat | (Jes (No
Dublc postion by a Couch of State member? Counc of Sate members ae hed | 11 or proceed to
in question 16. Question 18.
e. If 50, you must indicate whether during 2017 you (not immediate fori
members) engage in any of th folowing actitics wit respect to or on behalf of
the candidate ar campaign committe ofthe Counci of State member Who
20ponted you to your pubic postion
Oves OMe
i. Collected contributions from multiple contributors took possession of such
mulile Contributions, an transfered or delered those colected
Contributions to the candidate or committee? Conriotions are defined in
Question 16.
il, Hosted a fundraiser at your residence or place of business? [Ove One |
i. Volunteered for campaign related activities, which indude, but are not imited
to, phone banks, event assistance, malings, canvassing, surveying, or amy | (Jes (1No
ther activity that advance the campaign of a candidate”
18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon of innocence; or (i) an |
order of expungement regarding that convicon?
Oves Jano
Offense County of Conviction State of Conviction
19. Ae you aware of any other information tht you believe may assis th State Ethics Commission n advising you
Concarming your compliance wih the State Government Ethics Ac?
ves Io ites, pease provide such infomation below:
The SEX and any attachments, excluding the Confidential Form, are public records. Pages or 10
AFFIRMATION
1 affirm that the information provided in this Statement of Economic Interest and any atiachment hereto ae rue, complete,
and accurate to the best of my knowledge and belief
1 aso certify that 1 have not transferred, and will no ransfr, any asset, ineret, or property for the purpose of concealing it
from disclosure while retaining an equitable interest.
understand that my Statement of Economic Interest and any attachments or supplements thereto (wih the exception of the
| Confidential Form regarding Unemancipated Children) are public record.
acknowledge that | have read and understand N.C.G.S. 138A-26 regarding concealing or failing o disclose material
information and N.C.G.S. 138-27 regarding providing alse information:
| §138A26. Concealing or filing to disclose material information
ona statement of economic interest under this Article shall be guilty ofa Class | misdemeanor and shall be subject
| todisciplnary action under GS. 1384-45
| § 1384-27. Penalty for fase information.
A filing person who provides flse information on a statement of economic interest as required under this Aricle
kaowing that the information s false is guilty of a Class H felony and shall be subject to disciplinary action under
GS. 138A.
| Bertaene Cotas © pone footy 2018
Signature Bate
Barbera Campbon DAVYS
Printed Name |
Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. __
The SEI and any attachments, excluding the Confidential Form, are public records. Page 10.0f 10
2017 Edgecombe Community College Trustees
Document text
#5 NORTH CAROLINA STATE ETHICS COMMISSION [rome
dh ote Receives:
14 py 2017 STATEMENT OF ECONOMIC INTEREST
: NO CHANGE FORM » : BE
Checked for competion AX
THIS ENTIRE FORM MUST BE COMPLETED TO [scanned ov.
FULFILL YOUR ETHICS FILING OBLIGATION - .
Entered in 08.3/lLby_2*
FILER’ NAME (FIRST, MIDDLE, LAST)
[prefix [__rirst Name visas Name Cast name [sutin |
Barbe rp be Davie 1
REASON FOR FILING (COMPLETE ALL THAT APPLY)
‘STATE GOVERNMENT J0B (Specify Agency and Paston) | BOARD/COMMISSION (List the complete name of al State
boatds on hich you are serving o are bend considered
Edgecomb Commun Glo
JUDICIAL OFFICER (Specty Office) LEGISLATOR (Spelt House or Senate)
AFFIRMATION
firm that the information provided i this Statement of Economic Interest and any attachments hereto are true,
Complete, and accurate to he best of my knowledge ond belie.
alo certy thet have not transferred, and wil not transfer, any asset, interest, o property for he purpose of concealing
(fam Giscosure whi retaining an equtabi Interest
{understand that my Statement of Economic Interest and any attachments o supplements thereto (with the exception of
the Confidential Form regarding Unemancipated Chigren) ae public record
1 acknowledge tht 1 have read and understand §.C.G.S. 136-26 regarding concealing or falling to disclose material
information and N.C.G.5. 138-27 regarding prow ding fase informations
§ 138A26. Concealing or falling to disclose materia information.
A fling person who knowingly conceals or knowingly als t disclose information tha fs required to be disclosed on
2 atament of economic merest under tis Arie shall be guIty of a Class misdemeanor and shall be subject to
disciplinary action under G.S. 138-45.
§ 1388-27. Penaty for fase information
A filing person who provides fase information on statement of ecanemic interest a required under this Arie
Knowing that he Information 1 false 1 Gulky of 3 C125 H felony and shall be sublet to iscplinary action under
G's. 138045
I hereby affirm that 1 have reviewed my most recently filsd 2016 Statement of Economic Interest and that as
of December 31, 2016, my responses continue to be true, correct, and complete to the best of my knowledge.
and belief,
1 Agree
3
8 anirone Coppin Dagess 2/2017
| Signature ate
| Berber Campbell DAV
Printed Name
Submit SIGNED, ORIGINAL documents only. Do, not fax or e-mail this form.
This entire document is a public record.
2016 Edgecombe Community College Trustees
Document text
Zs, NORTH CAROLINA STATE ETHICS COMMISSION (rr cres comes vse ony
Er Cate Receive
4 Pa 2016 STATEMENT OF ECONOMIC INTEREST
NO CHANGE FORM "
cheseas tor completion 2
THIS ENTIRE FORM MUST BE COMPLETED TO | sco [oui 2 0%
FULFILL YOUR SEI FILING OBLIGATION
entered in 08 B22
FILER'S NAME (FIRST, MIDDLE, LAST) _ 1
bret | Fro ame rr BT 1
Mg Barbe,e [Comp iy TY —
REASON FOR FILING (SELECTALL TWATAPPLY)
[J STATE GOVERNMENT 0B (Please specify the agency for | [] EOARD/COMMISSION (Pease list complete name of all
which you work or are being considered) ‘State boards on which you are serving or are being
ended
I UBICIAL FFICER (ss spec ate you le _- TEGISLATOR (Posse pucty Howse a Sens) —]
I |
AFFIRMATION —
firm that the information provided in this Statement of Economic Interest 3nd any attachments hereto are true,
Complete, and accurate t the best of my knowledge and beliel
1 also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing
it from disclosure while retaining an equitable interest.
| understand that my Statement of Economic Interest and any attachments or supplements thereto (ith the excestion of
Ine Gonfantal Form regarding Unemancpated Children) ae public record.
acknowledge that have read and understand N.C.G.S. 138A-26 regarding concealing or falling to disclose material |
ofarmatin and N.C.G.5. 1364-37 regarding providing false information: |
§ 1388.26. Concealing or filing to disclose material information.
fing person who knowingly conceals o knowingly fils to disclose information that i required to be disclosed on |
Cimento acne Interest under tis Arica shall be guity of a Class 1 misdemeanor and shall be subject to
Sscamar acon una 6.5. 1358.45 |
5 1388-27. penalty for fale information.
A Fling persan who provides false information on 3 statement of economic interest as required under ths Article
EB er arrose sos vs esi sci ander |
iat hes
I hereby affirm that T have reviewed my most recently fled 2015 Statement of Economic Interest and that as |
of December 31, 2015, my responses continue to be true, correct, and complete to the best of my knowledge |
and belief. |
£1 Agree |
£5 ovrean Comets D on Faohnce oF dole |
Sates ae TT |
PBorbare Campbeli BAsC |
ECT — |
Submit SIGNED, ORIGINAL documents only. Do no fox o email tis farm. |
This entire document is a public record.
2015 Edgecombe Community College Trustees
Document text
7%, NORTH CAROLINA STATE ETHICS COMMISSION _—
ane
bl : Pr 2015 STATEMENT OF ECONOMIC INTEREST | FOR ETHICS COMMISSION ust ony
919-715-2071 www. ethicscommission.nc.gov 0 as 24 B12
FILER'S NAME (FIRST, MIDDLE, LAST)
ARNARA [CameneEr] ORV S
CURRENT EMPLOYER 308 TE
e fie
REASON FOR FILING (SELECT ALL THAT APPLY)
[J STATE GOVERNMENT JOB (Please specify the agency for TREoARD COMMISSION (Please list complete name of all
‘Which you work or are being considered) State boards on which you are serving or are being
considered
z
Shgecombe Common ty olla,
Boer) oq Tros tecc
C1 UDICIAL OFFICER (Please specify the office you hold) _| [J LEGISLATOR (Please specify House or Senate)
Do other immediate family members reside in your household?
Yes Oto
nen used throughout ths form, the term Immediate family includes your spouse (unless legally separate). It also
Includes members of your extended family (your and your spouse's children, orandchildren, parents, grandperents, and
| siblings, and the spouses of ‘each of those persons) who reside in your household.
ONLY LIST THE INITIALS OF UNEMANCIPATED CHILDREN. However, you MUST submit the children’s full names on the
Confidential Form available at the end of this document.
Minors are emancipated by marriage, enlistment in the US miltary, or court action for emancipation.
FULL NAME OF ADULTS & | RELATIONSHIP [| mweoven | osTme | NATURE OF
EMANCIPATED MINORS BUSINESS
0 Py
PttrvclackSroat | — 1 — [ — |
The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10
INITIALS FOR NATURE OF
UNEMANCIPATED popbaiag
CHILDREN
PROPERTY INTERESTS
1. As of December 31, 2014, did you, your spouse, or 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?
fives Ono
|___owner of Reat estate | o% Ownership Interest | Location by city Location by County
8. Lease or rent real estate or personal property $0.0 from the State of North Carolina with @ market value of $10,000
or more?
Oves Jno
1f Real Estate, Location | If Personal Property,
by City & County Describe
2. At any time during 2013 or 2014, did you, your spouse, or members of your immediate family sell to or buy from the
State of North Caroling persona property with a market value of $10,000 or more?
Oves no
Name of Purchaser [ Nameorseter | Type of Property
The SEI and any attachments, excluding the Confidential Form, are public records. Page 20f 10
FINANCIAL INTERESTS
3. As of December 31, 2014, did you, Your spouse, of members of your immediate family own any of the following financial
interests volued ot $10,000 or mare?
A. Stock in a publicly owned company?
Oves fino
00 not list ownership 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
Giversiied; and (i) nelther you or an immediate family member are able to control the assets held In the mutual fund,
investment company, or pension or deferred compensation plan.
B. Stock Options in a company or business?
OYes Who
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 (including interests in sole proprietorships,
partnerships, imited partnerships, Joint ventures, limited labilty companies, imited labity partnerships, and
Closely held corporations)?
Des N(No - If "No, proceed to question 4.
Owner of Interest Name of Company or Business Entity
The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10
€.(1). For each non-publcly owned company or business entity (the “primary company”) identified in question 3.C
above, 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, f known.
Non-Publicly Owned Company or Business Entity ‘Other Companies In which the Primary Company
(the Primary Company) ‘Owns Security or Equity Interests
C2). If you know that any company or business 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, provide a brief
description of that business activity.
Name of Company or Business Entity Description of Business Activity with the State
TR fone or fot Known
4. As of December 31, 2018, were you, your spouse, or members of your (mediate family the beneficiaries of a vested
trust with a value of $10,000 or more that was created, established, or controled by you?
Do not lst assets held n blind trusts. See 2015 SEI Helpful Tos for the definition of "Vested Trust” and "Blind Trust”
Oves (yo
Name and Address of Trustee Description of the Trust Your Relationship to the Trust
5. As of December 31, 2014, did you, your spouse, or members of your (mmediate family have liabilties of $10,000 or
more, excluding the mortgage on your primary personal residence? Examples. Include credit card debts, auto. loans,
Student Ioan, personal loans and intra-family debt.
Ses Ono
Name of Debtor (You, Spouse, Immediate Family Type of Creditor (Commercial Bank, Credit Union,
Member) Individual, etc.)
[Barbar Compr llofs | Creldunion
The SEX and any attachments, excluding the Confidential Form, are public records. Page 40f 10
6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of
your’ immediate family during 2014. Include salary, wages, state/local government retirement, professional fees,
[11 had no reportable income over $5,000 in 2014.
Berbera Corpuintns Lrats’sgo] Chord. [Tension |
PROFESSIONAL AND CIVIC RELATIONSHIPS
Yes [No - If "No, proceed to question 8.
gry GORY s | Preside, Edged WEG
7(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive
| Faeroe Rove, Melova gp Ne Pts Covny,
“The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10
8. During 2014, were you, your spouse, or members of your [mmedate family a director, Sficer, or governing Board
member of any Society, organization, or advocacy group ith an Interest In matters over which your agency or board may
Rave jurisdiction?
ives IiNo [)Legisiator/udicl Officer - You are not required to complete this question i you ae fing because
you are a legsitor or Judicial officer o you are fing as an appointee 10 those afices
»Do not st organizations of which you are only 3 member (not Serving n a leadership role).
Name of Society, Organization Leadership Position |
or Advocacy Group (Director, Officer, Board Member)
9(a). Lit the name of each company or 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, 2014.
9(b). If you know that any company or business entity listed in 3(a) above had any material business dealings or business
Contracts with he State of North Carolin or was reguiated by the State a6 of December 31, 2014, provide a brief
description of that business activity.
Name of Company or Business Entity Description of Business Activity with the State
{Not applicable (No entities Ited on #52) CJ No relationship / Not known
10. Ave you's practicing attorney?
Doves Wo ua cess ame
11 Yes, check each category of legal representation in which you of the law firm with which you are affliated hes carned
legal fess of more than $10,000 during 2014.
0 Administrative Admiralty OCorporate criminal
Decedent's Estates DEnvironmental Clinsurance Cltabor
Local Government Real Property Securities Oar
ort isgation (including 0 tities Regulation CJ Other category not sted.
negligence)
The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10
11 Duin 201s, were you 3 Icensed profesional (over Fan a Soren) od you prove ceding sees
GABA 35 amber of praresoner secon for wha You Charges Fre aos vos eaten
Oves Wo
Type of Business Nature of Services Rendered
To re ou oF you aleyer, yur speves or aes of yout ite Toi or Tot oT
Licensed by the Stat board or employing entity with hich you ar or il be associated or
+ Regulated by the State board or employing entity with which you are or will be associated or
+ Have a business relationship with the State board or employing entity with which you are or will be associated?
Dives ino Celtic Ofer You re not eure o complete this custo you are fing because
‘you are a legislator or a judicial officer (“judicial officer” is defined in the SEI Helpful Tips) or you are
Tews on a appa to ass ees
Name of Employer Type of Relationship
(if applicable) (Licensing, Regulatory, Business)
5. Ar you, your spouse or 8 member of your Inada amily curently regsared 5 OGY o obo pn or
were you registered as such within the 12 months preceding your filing of this form?
ves Mo
Name of Lobbyist Lavayiats principal bare of Registration
Repomanon | "Sepration
OTHER DISCLOSURES
14. During any calendar quarter in 2014 (but only the time period after you were appointed, employed or filed or were
Hermanas a conan. au vou
+ receive any "gift(s)" exceeding $200 per quarter from a person or group of persons acting together, and
+ when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and.
~ tn f(s) wer vn under cumstances that wold lad essa parson concld tht hey were given or
ovens?
Ove ge
»Do not report gifts given by members of your extended family.
¥ Do rot repo its tha hve previously bee reparted 1 yout he Depariment of the Secretary of Sia on the
ES pons Report or Evemine Bsns”
Name and Address of Domor(s) | Deserve Tem Received | Estimated Market Value
The SEL and any attachments, excluding the Confidential Form, ars public records. Page 7 ar 10
A Saredig (but only the time period after you were appointed, employed, or filed or were nominated as 2 candidate)
+ accept a “scholarship” exceeding $200 from a person or group of persons acting together and
+ those person(s) were outside North Carolina and
+ the scholarship was related to your public position? A “scholarship” is a grant-in-aid to attend a conference,
OYes ? No [J] Judicial Officer - You are not required to complete this question if you are a judicial officer or you are
the General Assembly is a member or participant or an affiliate of that organization.
Date of Name and Address of Donor(s)
ar 5
If “Yes”, list all contributions you (NOT immediate family members) made during 2014 with a cumulative total
whatsoever,”
Tee Tew] come
[—————] I |
2. he bend of principal sate German (5. abet sere) Sppoied by
b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court
3 mrmr of any of te flavin boards
hac Commason
Comat Resoes Commision
Ste Beard of Saucon ves Jie
~ Divs or Employment Sect 3 ner, proceed to
~ Ervremmana Sanoganne Comission Section i8.
RC Sor of Governors
Ee ot Pe | Yee EM ea 0
fr eston i6.
© am ya mo ce thr dig 207 yo rt ede ary ees)
[Yes [No
i. Cole contains rm mui cotiutors, took possession of such
ii. Hosted a fundraiser at your residence or place of business? Yes [No
i Votreere or cpa aated cvs, which nude, bt ae ot Iie
Serves ta samen te ampmon or coeotr
TS Tavs you eve ben coi of a fly To which you Nave ek ecaved aha: 1 pardon of roceeer a (97
ns ha Son?
EC
orense Save of Conviction | County of Conviction |stats of comvicion
To hee you aware of ry her eras a yo belle may 3th Ste EGS Cason 3345 You
ncaa re Ste vet oes 218
Yes ad 1f yes, please provide such Information below.
The SE an any attachments, xclcing the Conidentin Form, are public records. rage sot 10
AFFIRMATION
affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete,
and accurate to the best of my knowledge and belief.
1also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it
from disclosure while retaining an equitable interest.
Tunderstand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the
Confidential Form regarding Unemancipated Children) are public record
acknowledge that ave ead and understand N.C.G:S. 138A-26 regarding concealing or fing to disclose materia
information and N.C.G.S. 138-27 regarding providing false information:
§ 1381020, Conceting os fing odie ets formation.
A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a
Statement of economic interest under this Article shall be guilty of a Class | misdemeanor and shall be subject to
disciplinary action under G.S. 1384-45.
§ 138A-27. Penal for ls information.
A ing por wo provides fle information oma sttemest of econ interest as reqived under this Avice
knowing that the information is false is guilty of a Class Hl felony and shall be subject to disciplinary action under G §
138Ads.
K1 Agree
Borbere Campbell OAs
Printed Name
Barkan CoppenD pres Boge 21, D0 | 5
Signature Dats
Submit SIGNED, ORIGINAL documents only.
Do na fax or emai this orm.
The SEE and any attachments, excluding the Confidential Form, are public records. Page 1001 10