Barbara Reynolds Valentine

, NORTH CAROLINA STATE ETHICS COMMISSION | ro Ernics comission use oxy {ly 2016 STATEMENT OF ECONOMIC INTEREST oes . | 919-814-3600 wav CLhiCSCOMMISSon. nC. gov ee WE C01 THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL anion eine YOUR SEI FILING OBLIGATION ared id Incomplete 2s _ i Supp. Sent Dare or Supp. Received Date . | enterea in sotavasesfefie ey Be FILER'S NAME (FIRST, MIDLE, LAST) i Pretix_| First Name Middle Name [ Lost Name Suffix CURRENT EMPLOYER | soa mine i | fe wa NATURE OR TYPE OF BUSINESS oo | REASON FOR FILING (SELECT ALLTWAT APPLY) __ _ oo | CI STATE GOVERNMENT JOB (Please specify the agency | (5) BOARD/CGMMISSION (Please ist completa name of all or which you work or are being considered) State boards on which you are serving or are being | JE _ | considered) = mm i J JUDICIAL OFFICER (Please specify the office you hold) | [] LEGISLATOR (Please speci House or Senate) i | A. Do other Immediate Family members reside in your household? [Cvs 3% | When used throughout this form, the term 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 linge, and the spouses of each of those persons) who reside in your household. | | List the full name of all adults ana emancipated minors in your household. A minor is a child under 16 years old Minors are emancipated py marriage, enlistment in the US miltary or court order for emancipation. BN FULL NAME OF ADULTS & | RELATIONSHIP EMPLOYER | JOBTITLE | NATUREOF | EMANCIPATED MINORS | : | eustness an - _ | — L { i | - - _ - 1 - | | The SET and any attachments, excluding the Confidential Form, are public records. Page 1of 10 B. List ONLY the initials of ll unemancipated minors in your househaid below. A minor s a chid under 18 years oid. Minors are emancipated by marriage, eakstmant in the US milkary or court order for emancipation Note: You must list the full name of each minor child on the Confidential Form available at the ____end of this document. ___ — | INITIALS FOR | RELATIONSHIP EMPLOYER 308 TITLE NATURE OF UNEMANCIPATED BUSINESS MINORS ~ wa | | PROPERTY INTERESTS. 1. AS of December 31, 2015, did you, your spouse, or members of your immediate fomiy: A. Have an ownership Interest in North Carolina rea estate (including your residence) with a market value of $10,000 or more> Eyes Ovo Owner of Real Estate “% Ownership Interest Location by City Location by County L : SR — 8. 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? Oves No Name of Lessor Name of Lessee | If Real Estate, Location | If Personal Property, | (Renter) by City & County Describe 2. AC any time during 2014.0: 2015, did you, your spouse, or members of your immediase family sel to or uy from the | State of Narth Carning personal property with a marke value of $10,000 or more? Oves (ino Name of Purchaser © Nemeotsemer | Type of Property The SEI and any attachments, excluding the Confidential Form, are public records. Page 201 10 FINANCIAL INTERESTS 3. Af Decemba 31, 201, you, you suse, o merbars of your mmcdat fay ow any f th flowing inancol A. Stock in 2 publicly owned company? t LAC LT — — NT ona or person or deferred companion san) 1: ) ihe und. pub 30nd 3 a ests. a wey Owner of terest 1" Full Name of Company (bo not use a ticker symbol) B. Stock Options in a company or business? OvYes [@No Owner of Stock Option Full Nome of Gompany (Do not use a ticker symbol) | | C. Interests in a non-publicly owned company or business entity (including interests in sole proprietorships, | partnerships, limited partnerships, Joint ventures, limited labiity companies, limited ability partnerships, and [As Owner of terest | Name of Company or Business Entiy | Non Publicly Owned Company or Business Entity | Other Companies in which the Primary Company | | (ve Pormary Compan wna Sacto Eaany tmmorasts | | ! C2). 1F you know that any company o business entity listed in 3.C or 3.C(1) above has any material business | Gealings or business contracts wih the State of North Carolina, or is regulated by the State, provide » brief description of that business acto | Name of Company or Business Entity. | Description of Business Activity with the State | KC Nore or Not known 4.” As of December 31, 2015, were you, your spouse, or members of your immediate family the beneficiaries of vested | trust with 8 value of $10,000 or more that was created, established, or controled by you? D0 it st assets held in bind trusts. See 2016 SET Helpful Tips for the definition of "Vested Trust” and "Bling Trust” Cves Who Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2015, did you, your spouse, or members of your immediate family have labiltes of $10,000 or ore, exclLding the mortgage on yaur primary personal residence? Examples includ credit ard debs, auto loans, student. Ioans, personal loans and intra-faiily Get | Ove mn Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) Individual, etc.) 1 6. List cach saurce of income (not specific amounts) of more than, $5,000 received by you, your spouse, or members of your immediate amily during 2015. Include salary, wages, state/local goverment retirement, professional fees, Ronoraria, interest, dividends, rental income, business income, and other types of income reauired to be reported on your | State and federal ta retums. 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 Type of Income | Bsiness/Industry [1 hod no reportable income over $5,000 in 2015 : . I The SET and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 PROFESSIONAL AND CIVIC RELATIONSHIPS Bo not list State boards or entities, or entities created by a political subdivision of the State. oT oo " ch ore mere pom rg | I [¥] None or Not Known . During 2015, were you, your spouse, or members of your immediate family a director, officer, or ‘governing board i have junsdiction? | [7 Name ot person Name of Society, Organization | Leadership position | or Advocacy Group (Director, Officer, Board Member) (a) List the name of cach company or business with which you were associated where you or 3 member of your Immediate | | family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2015. | | amet per son | Relationshiptofiler | Name of Company | Role of Person { 3 No Business Associations - If "No," proceed to question 10 | I | | | | | | | frome i + — 9(0). If you know that any company or business entity sted In 9(a) above had any material business dealings or business contracts with the State of orth Carolina or was regulated by the State a5 of December 31, 2015, provide a brief description of that business activity. Name of Company or Business Entity | pescription of Business Activity with the state 1) Not applicable (No entities sted on 49a) | No relationship / Hot known resin e———————————————————————— } 10. Are you 2 practicing attorney? OYes [No [}udical Offcer/State Attorney "Yes", check each category of legal representation in which you or the law firm with which you are affiated has cared egal feés of mare than $10,000 during 2015. [3] Agministrative [1 Agmiraity J Corporate. [1] Criminal | [0 Cecegents Estates (0) Environmental insurance [J tavor | 0 toce! Government Rea Property 13 Securities rex | Ctert tiation (including Unites Reautation [other category not listed. | negligence) [ 11. During 2015, were you 3 licensee professional (other than an attorney) or did you provide consulting services | individually ar as a member of a professional association for which you charged or were paid over $10,000? | ves wwe [ Typeet Business I Nature of Services Rendered | | ture of Service er - - The SEI and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 | 12. Ave 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 + Requitert by the State board or employing entity with which you are of wil be associated or | | + Have a business relationship with the State board or employing entity With which you are or wil be associated” [ves [No (Legislator Judicial Officer - You are not required to complete this question If you are fing because you are a leqrator of a Judicial tier (“judicial officer” is defined in the SEI Helpful Ts) or you | are Ging a5 an appointee to those offices. | sere 0 Spo src — Name of Person Name of Employer I Type of Relationship | | (if applicable) | (Licensing, Regulatory, Business) | —T | | — J | i [ 13. Ave you, your spouse or a member of your immediate family currently registered as a 19bbyist o lobbyist principal, or Were you registered as such within the 12 months preceding your ing of this form? | ove me I Name of Lobbyist | Lobbyist's Principal | bateor | Registration | | Registration Expiration | | | | | omer piscLosures | 14. During any calendar quarter in 2015 (but only the time period after you were appointed, employed o filed or were. | | cominated as § candidate), 6d you | | receive any *ait(s)” exceeding $200 per quarter from a person or Group of persons acting together, and | | when both you ond those person(s) were outside North Carolin at the Ume you accepted the G(s), and | to vars ond vce ot wee 8 resonable prc to coca sa they were vr | for lobbying? | ove we I> Ba mat report ots ven by members of your extended omy. A | +00 not report gifts that have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted Persons.” ll Date Item Received | Name and Address of Donor(s) | Describe Item Received | Estimated Market Valve i | | The SET and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 | 15. During 2015 (but anly the time period after you were appointed, employed, or filed or were nominated as a candidate) | cid you i accept a scholarship” exceing $200 frm person o group of persons acting ogether and | + those person(s) were outside North Carolina and | | + the scholarship was related to your public position? A “scholarship” is a grant-in-aid, either direct or indirect, | fo attend conference, mocking, or Similar event, including tufion, travel, aging, meats, and other Similar expenses. ves 50 [3 deal Officer - You ae not required to compete this question f you are 3 judicial afice or you are ing a cal officer apponies + Do not report git that have previously been reported by you to the Department of the Secretary of State an the | Ermer pinto emg rons” » Legicatrs are not required to report scholarships pai by 3 nonpartisan legislative organization of which the leisator ar the General Assembly 5.0 mtmber or Prtpant of on iTHate of har organization | Date of Name and Address of Donor(s) | Describe Event Estimated Market | Scholarship [TR | 16. Were you appeinied o are you being considered or 3 PPI to 3 covered board by the Govermor or anather Counc of State member? Council of State members are: | » Governor » Lt. Governor > Secretary of state » state Auditor » tte Treasurer > Superintendent of Pubic Instruction |» acomey Genera » Commissioner of Agricuture ~~» Commissioner of Labor | » Commissioner of Insurance Cves mo 16 "Yesr, is al contributions you (NOT immediate family members) made during 2015 with a cumulative Totarof more thon $1,000 1 the Governor or other Cauncl af State member who appointed you. | » Contributions are defined in N.C.6.5. 163-276.6(6) and include, but ar: nck Wied £, “any vance, conveyance, Capos, dito on ania of funds an, payment, i, leds or UbSCTBNGn of money or anything of vase | evar Tm rr 5h comabution(:) wilh 4 umative oral of more than $1,000 | The SEI and any attachments, excluding the Confidential Form, are public records. Pages of 10 17. Ace you an appointee or prospective appointee to: | a. the head of a principal state department (e.g. cabinet secretary) appointed by the I Governors or |b. a oth Carolina Supreme Count Justice Court of Appeais, Superior or ise | | Coumudge or i | a member of any of the following boards | k » ABC Commission I! | + Coastal Resources Commission | | + State Board of Education [ives [No | © State Boars of Elections | © Dusan of Employment Security I Nos proceed to i © Environmental Management Commission | question sa. © tndustria Commission | « Human Resources Commission | | + Rules Review Commission | | | Board of Transportation | | JS bin wi | a ia. we yo oon are evn comes tr ppt nt Cives Cie 1 BC Cone of Sk mer? Cou State MEMOS 668 | 14 “ho” procesd to Wavedton 1 Question 18. e. 1 so, you must indicate whether during 2015 you (not immediate family emiers) anaoged in any of the foaming actites wl Fespect to o on behalf of The candidate of camparan committee of the Council of State member who appointed you to your public positon: Des Ono 1. Collected contributions fram mutiple contributors, ook possession of such kip contributions, and trancierred or dewercd those collected | Question 16, | | il. Volunteered for campaign-related activities, which include, but are not limited | | To Shor bart, cut ass stance, maiings, canvassing, surveying, or any | [Yes (No. | other activity that advances the campaign of a candidate? | | | 15. Have you ever been convicted of a felany for which you have not received either: (i) 3 pardon of innocence; or (1) an | | order of expungement regarding that conviction? | | aves @m [ offense | Date of Conviction | County of Conviction | State of Conviction 19. Are you aware of any other information that you believe may assist the State Ehics Commission in advising you | Concern your compliance wii the State Government Ethics AC? | | Cree ha ye, on reese tron. | nm. J The SEX and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 AFFIRMATION 1affiom that the information provided in this Statement of Economic Interest and any attachments hereto are tue, complete, | and accurate to the best of my knowledge and belief from dislovure while retaining an cquifable interest 1 | 1 understand that my Statement of Economic Interest and any atachments or supplements thereto (with the exception of the | Confidential Form regarding Unemancipated Children) are public record. | acknowledge that have read and understand N.C G.S. 138A-26 reparding concealing or failing 10 disclose material | information and N.C.G.5. 1387-27 regarding providing false information: | § 1384-26, Concealing or failing to disclose material information | A fling pecson who keowwingly conceals or knowingly Fails disclose information that is euired to be disclosed | | oa statement of como crest under this Atticle shall be guilty of Class | misdemeanor and shall be subject | To disciplinary action under G5. 38745. | | §138A-27. Penalty for false information. I A filing person who provides false information on a statement of economic interest #5 required under this Article | Knowing tha the information is fale is guilty of a Class H felony and shall be subject to disciplinary action under | GS 13A-5 | G1 Agree 5 Tat. 4 APSE Signature N bate Barbara Feats ies rime. Printéd Name Submit SIGNED, ORIGINAL documents only. Do nat fax or email this farm. SE The SET and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

NORTH CAROLINA STATE ETHICS COMMISSION 2015 STATEMENT OF ECONOMIC INTEREST No-Change Form FILER'S NAME (FIRST, MIDDLE, LAST) First Name Middle Name Last Name Suffix Barbara Reynolds Valentine REASON FOR FILING (SELECT ALL THAT APPLY) STATE GOVERNMENT JOB (Please specify the agency for which you work or are being considered) BOARD/COMMISSION (Please list complete name of all State boards on which you are serving or are being considered) Tryon Palace Commission; JUDICIAL OFFICER (Please specify the office you hold) LEGISLATOR (Please specify House or Senate) The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 2 AFFIRMATION I affirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. I also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the Confidential Form regarding Unemancipated Children) are public record. I acknowledge that I have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest under this Article shall be guilty of a Class 1 misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest as required under this Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I hereby affirm that I have reviewed my most recently filed 2014 Statement of Economic Interest and that as of December 31, 2014, my responses continue to be true, correct, and complete to the best of my knowledge and belief. I Agree. It is my intention that this check box constitutes my electronic signature. By checking this box I certify that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. Barbara Reynolds Valentine Printed Name Filed Electronically 3/19/2015 Signature Date The SEI and any attachments, excluding the Confidential Form, are public records. Page 2 of 2