Barbara Ross Kornegay

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 Dr. Barbara Ross Kornegay 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.) Eastern Carolina RPO (TAC) Judicial Officer, Post-Service Filer, or Appointee (Specify office) Legislator, Post-Service Filer, or Appointee (House or Senate) This entire document is a public record. AFFIRMATION I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue to be true, correct, and complete to the best of my knowledge and belief. I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my No Change Form is a public record. I have read and understand the following statutes: N.C.G.S. § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary action under G.S. 138A-45. N.C.G.S. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 04/14/2025 Signature Date Barbara Ross Kornegay Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

OR STAFF USE ORLY Go STATE ETHICS COMMISSION Oat Received Gy 2024 STATEMENT OF ECONOMIC INTEREST RECEIVED 3 MPO/RPO TAC No Change Form May 8 This entire form must be completed to fulfill ne MISSION your SEI filing obligation. NCETHICS COM [Bebe | Rice | bpnoge || Reason for Filing (Complete all that apply.) ‘State Government ab (Speci agency and postion) | Boara/ Commission (List the complete names of Sate boards ar TACS on which you are senang or are being considered) [| fiden Conti Rnd Plein | Currently Serving 95 Juda Office (Speci office) | Carrnty Serving 8 a Lisa (Spey House or Sénatd) ve You 3 CANDIDATE for a covered lected office? | 1f yes, speciy office and district county If applicable: (District Supreme, or Superior Court; Court of Appeals; Clrk of Court; A; Legislator; Member, Councl of State) Oves @no AFFIRMATION have carefully reviewed my most recently fied Statement of Economic Interest Long Form and my respanses continue be tue, correct, and complete t th best of my knowiedae and baler. have not transfered, an will not transfer, any asset, interest, or property for the purpose of concealing it from closure whe retaining an equitable eres. understand tht my No Change Form is a public record. 1 have read and understand the following statutes: NCGS. § 1384-26. Conceaing o falling to disclose material information. A fing person who knowingly conceals or knowingly fis to cscose formation that required to be disclosed On Stterent of Cane Interest shall b gui of Class 1 misdemeanor nd Subject 0 daphnary Scion under G.5, 139845: NCGS. § 1384-27. Penaty for fle information. A fing person who provides flse information an statement of sconomic interest... knowing that the Infomation 1 asa 15 uty of 5 Cass feany and shal be subject to dsdpinary action under G.5, 1308-45. affirm under penalty of perjury that the foregoing is true and correct. IG a 5/2] 202 Sigmature Bae Paden Foo Kornesy Printed Name Ci Submit signed, original documents anly. Do not fax or e-mail this form. This document is a public record.

oR ST SE OY 8 STATE ETHICS COMMISSION Dike Received; x ) vy 2023 STATEMENT OF ECONOMIC INTEREST ECE] No Change Form This entire form must be completed to fulfill your SEI filing obligation. JC ETHICS COMMISSIO! 5 | Bobea [ss | Koneaee | | Reason for Filing (Complete all that apply.) Soe Government 3 (Specty sgency and postion) | Board/ Commission (isto complete names oo Ste Eoergs an wh you arc serving a ar bag comer) Currently Serving or Served as a Judicial Officer in 2022 | Currently Serving or Served as a Legislator in 2022 (Specify. (Spec ce eg oder co of Sorts dts aor.) Hoon of Sete) ArrRATION have careful reviewed my most rectly fled Statement of Economic Interest Lon Form and my responses canine 1 oe trae, Cotes, and comple a he 50 of oy nowiedge and pete have not transferred, and wil not transfer, any asset, interest propery for the purpose of concealing i fom klosue whl retaining an eQuRabe terest understand hat my No Change Form is pul record. hove rend and understand th following statutes: N.C.G.5. § 138-26, Conceling or fling to disclose material formation, A fling person who knowingly conceals or knowingly fal to dios information tht is required tobe disclosed on Siment of Sono Mere Shall be Jy of 5 Clo 1 Thsdemeaner ond wee 10 disci Chon ander G. 15onets. N.C.G.5. § 138-27. Penalty for fle information. A ling person who provide alse. information an a statement of economic nferest knowing that he Inormetion fl 1s gut fa Clos 1 elon and hal be subject to Gcipinary con under G3: 1304-45, affirm under penalty of perjury that the foregoing is true and correct. / 2nd? far //27)n23 Sighatire oa Prac Foss 1 (nega, Printed Name ‘Submit signed, original documents only. Do not fa or e-mail this form. This document i a public record.

This entire document is a public record. STATE ETHICS COMMISSION 2022 STATEMENT OF ECONOMIC INTEREST NO-CHANGE FORM ELECTRONIC FILING This entire form must be completed to fulfill your ethics filing obligation. Filer’s Name (First, Middle, Last) Prefix First Name Middle Name Last Name Suffix Dr. Barbara Ross Kornegay Reason for Filing (Complete all that apply.) Are you a CANDIDATE for elected office? ☐ Yes ☒ No If yes, for what position are you seeking election? (Specify name of office seeking in box below.) Do you currently hold this position? ☐ Yes ☐ No State Government Job (Specify agency and position.) Board/Commission (List the complete names of all State boards on which you are serving or are being considered.) Eastern Carolina RPO (TAC) Judicial Officer (Specify office.) Legislator (Specify House or Senate.) AFFIRMATION I have carefully reviewed my most recently filed Statement of Economic Interest Long Form and my responses continue to be true, correct, and complete to the best of my knowledge and belief. I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. I understand that my No Change Form is a public record. I have read and understand the following statutes: N.C.G.S. § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest . . . shall be guilty of a Class 1 misdemeanor and . . . subject to disciplinary action under G.S. 138A-45. N.C.G.S. § 138A-27. Penalty for false information. A filing person who provides false information on a statement of economic interest . . . knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. I affirm under penalty of perjury that the foregoing is true and correct. Filed Electronically 03/26/2022 Signature Date Barbara Ross Kornegay Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a public record.

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 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 Dr. Barbara Ross Kornegay Current Employer Job Title Town of Mount Olive Commissioner Nature or Type of Business Municipality 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.) Eastern Carolina RPO (TAC) 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 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, 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 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 10 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 C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the names of any other companies or business entities in which the Primary Company owns securities or equity interests valued at over $10,000, if known. Non-Publicly Owned Company or Business Entity (the Primary Company) Other Companies in which the Primary Company Owns Security or Equity Interests None or Not Known C (2). If you know that any entity listed in 3.C or 3.C(1) above has any material business dealings or business contracts with the State of North Carolina, or is regulated by the State, briefly describe that business activity. Name of Company or Business Entity Description of Business Activity with the State None or Not Known 4. As of December 31, 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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 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.) Barbara Ross Kornegay (Self) Commercial Bank 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 Barbara Ross Kornegay (Self) spousal trust investments Other type of income Barbara Ross Kornegay (Self) Town of Mount Olive municipality Salary The SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 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 10 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 No Business Associations 9(b). If you know that any entity listed in 9(a) above had any material business dealings or business contracts with the State of North Carolina or was regulated by the State as of December 31, 2020, briefly describe that activity. Name of Company or Business Entity Description of Business Activity with the State None or Not Known 10. Are you a practicing attorney? ☐ Yes ☒ No ☐ Judicial Officer/State Attorney 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 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 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 because you are a legislator or a judicial officer or you are filing as an appointee to one of those offices. Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal within the 12 months preceding your filing of this form? ☐ Yes ☒ No Name of Lobbyist Lobbyist’s Principal Date of Registration Registration Expiration Other Disclosures 14. During 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 8 of 10 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 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 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 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 05/12/2021 Signature Date Barbara Ross Kornegay Printed Name

The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 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 Dr. Barbara Ross Kornegay Current Employer Job Title town of Mount Olive Commissioner Nature or Type of Business Municipality 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.) Eastern Carolina RPO (TAC) 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 For Staff Use Only Date Received: 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, 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 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 10 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 C (1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the names of any other companies or business entities in which the Primary Company owns securities or equity interests valued at over $10,000, if known. Non-Publicly Owned Company or Business Entity (the Primary Company) Other Companies in which the Primary Company Owns Security or Equity Interests None or Not Known C (2). If you know that any entity listed in 3.C or 3.C(1) above has any material business dealings or business contracts with the State of North Carolina, or is regulated by the State, briefly describe that business activity. Name of Company or Business Entity Description of Business Activity with the State None or Not Known 4. As of December 31, 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 The SEI and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 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.) Barbara Ross Kornegay (Self) Commercial Bank 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 Barbara Ross Kornegay (Self) spousal trust investments 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 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 Barbara Ross Kornegay (Self) Employee University of Mount Olive private higher education 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 University of Mount Olive 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 10 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 Barbara Ross Kornegay Self University of Mount Olive Employee 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 University of Mount Olive None or Not Known 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 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 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 because you are a legislator or a judicial officer or you are filing as an appointee to one of those offices. Name of Person Name of Employer (if applicable) Type of Relationship (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or lobbyist principal within the 12 months preceding your filing of this form? ☐ Yes ☒ No Name of Lobbyist Lobbyist’s Principal Date of Registration Registration Expiration Other Disclosures 14. During 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 8 of 10 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 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 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 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 05/18/2020 Signature Date Barbara Ross Kornegay Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

oa FOR STAFF USE ONLY Ga) STATE ETHICS COMMISSION Date Received: {As RQ dl §/) 2019 STATEMENT OF ECONOMIC INTEREST f EZ NO-CHANGE FORM Checked for completion S15 This entire form must be completed to fulfil your scannea > _ ome 21] )11 ethics filing obligation. tis. Flers Nome (First, Middle, Last) 2 [prefix | pisthame | wiodieWame | iastheme | sumx orm Ms [Bana | Rose | Korma Reason fo ilng (Complete al that apply. State Government Job (Specly agency and position.) | Board/Commission (List the complete names of ll Sate boards on which you ae serving or are being considered.) Judicial Officer (Specify office.) Legislator (Specify House or Senate.) AFFIRMATION The information provided i tis Statement of Economic Interest and any attachments ar true, complete, and accurate to the best of my knawiedoe and belt have not transferred, and wil not transfer, any asset, Interest, or property fo the purpose of concealing it fom disclosure whi retaining an squtable terest Lunderstand that my Statement of Economic Interest and any attachments except or the Confidential Form Regarding Unemancpated Children publ reco. have read and understand th following statutes: N.C.G.S. § 163A-191. Concealing or failing to disclose material information. I A fling person who knowingly conceals o knowingly as to disclose information that is required tobe disclosed on statement of economic Interest. shll be GUI af a ins 3 misdameanr and Subject fo disciplinary acton Under G'S. 1638415. NCGS. 1630-192 Penalty for false formation | Afilng person who provides false information an a statement of economic Interest knowing that the information is alse uly of a Clas H eany and shall be subject to d5cpinary acon under G.6. 163A 415. Laffiem that I have reviewed my most recently fled 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue a be true correct, and complete 10 he best of my Knowieage and or. affirm under penalty of perjury that the foregoing is true and correct. 7A a_i nt Name Submit signed, orginal documents only. Do not fax or e-mail this form. | This entire document is a public record.

© 4% NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY JW": ELECTIONS AND ETHICS ENFORCEMENT Cate Receed: 4'@ 2018 STATEMENT OF ECONOMIC INTEREST | £ coolers Col aoe ib £O s15-814-2600 Pr—— EHR -8 pi 553 Checked for completion THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL | Sed One "YOUR SEI FILING OBLIGATION THEIPEE Pe om ce Supp. Sencate By Supp. Received ote entered in dotabase [— FILER'S NAME (FIRST, MIDDLE, LAST) Profix [FirstName [wiodie Name | Last Name [sumx_| 7 7 — viva b D ay Ms [Dodane | F | Korne ‘CURRENT EMPLOYER m Vio Te Uwensihn oF Mount Dlg [Ve Tmide wo lime [Naper education pavak REASGN FOR FILING (COMPLETE ALL THAT APPLY) STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (List complete name of all State boards on which you are serving or are being considered) dweissioner, Town of Mout Oe, 14 LEGISLATOR (Speaty House o Senate) A. Do ather immediate family members reside in your household? Oves Rud When used hroughot 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 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 househald. A minor i a chid under 18 years od. Minors are emancipated by marrage, enlistment In the US miltary, or court order for emancipation. FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER [ osmme EMANCIPATED MINORS | The SET and any attachments, excluding the Confidential Form, are public records. Page 10 10 3 Lt ONLY the iia of of snomanceted minors your Rouehl bon minr 2 hid and 18 Yes oi Note: You must ls the ull name of each minor child on the Confidential Form avalable at the ‘end of this document. InmaLs ror ATURE OF AA re ee MINORS \ 4 I EE A — eRoPERTY INTERESTS 1. As of December 31, 2017, did you, your spouse, or members of your immediate family: ave ar owners terest In Nort Cool rel stove (ncn you redone) with a market value of $1000 aes R(Yes [ONo Owner of Rear Estate| 5 ownership interest Mbp Tass onagal 335 | Claudo | Yost, | William Iss, J 337, [Te] ivy 0 uf B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of Site oro Ces Qo Fo Noms of Lasse | Real Este, Location | if Personal property, (Renter) by City & County Describe. TN, 2. At any time during 2016 or 2017, did you, your spouse, or members of your immediate family sell to or buy from the Seo rin Coro person rope who mame vie 8 101208 or mores Oves Kino 7 i m———— . The SEX and any attachment, excluding the Confidential Form, ae public records. Page 20110 [FinaNcIAL INTERESTS 3. A of December 31. 2017, did you, your spouse, or members of your immediate family own any of the following financial | interests valued at $16,000 or more? LIST EACH COMPANY INDIVIDUALLY, | A. Stock in a publicly owned company? 1 ves [5 ot Ist phNership interests in widely held investment fund (including mutual funds, regulated investment ‘companies, br pension or deferred compensation plans) if: (1) the fund is publicly traded or I assets are widely Giversited; 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 pian. vara mres—]. el a fCompeny (ow sr ers NT — EE — 6. Stock Options in company or business? Oves [io File fam (5 er ess rsa | C. Interests In 2 non-public owned company or business entity (Including Interests in sole proprietorship, partnerships, mite partnerships, ont ventures, med ibllty companies, Imited labify partnerships, and | Closely held corporations)? | Ove Xflo- 100, proceed to question 4. TS RT Dee > rr] C (1). For each non-publicy owned company or business ently (the “primary company) identified n question 3.C. above, please fs the names of any other companies or business entities in which the primary company owns securities or equity interests valued at over $10,000, known. Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company woresrrene 08 CEINREY EoMpONY) Owns Security or Equity Interests Gone or ot known 1] | The SEL and any attachments, excluding the Confidential Form, are public records. Page3of 10 prot ee iy Ram of Company or ines Ent pT —r——— 4. As of December 31, 2017, were you, your spouse, of members of your immediate family the beneficiaries of a vested ee Come eae Do not list assets held in blind trusts. ve fo Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2017, did you, your spouse, or members of your immediate family have liabilities of $10,000 or Se DRL BE 06 ne Ln ty vs he 100 Sn ov ge Eo Tn —V [pT — TT Cm 6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of an os | State and federal tax returns. FO —— J conar gore vetoes met respons > Military retirement > Social security income/SSDL. | Pre A Tr — De imtsry [fade Rien Tasn Wont Ole Sela ; [| 7 - Bais Forancl Ph, Lf 50) Trsumer Fuad | Win. dish § Toe SE rd ary sche, coin the Content Farm, re bl cords. rasesotio "| PROFESSIONAL AND CIVIC RELATIONSHIPS 70). Dung 2012, wer you, your spouse or members of your Immediate family drecor, offer, governing board member, employes, independent contractor, or reatered Jboyit of 8 nonorft. orseraton o orgamEaLon operating | the State of North Carolina primarily for religous, charitable, scientific Ierary, pubic health and safety, or educations | purposes? ves fo 1 Wo proceed to question. 50 nt Fst Sto bourds or enfies, or nts created By 8 paVEkalsubavon of the Sate Do not Ist organizations af which you se » mere member. a ———— His/Her Position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organisation 705). 1 tne nonproft. corporations o organizations sed above do business withthe State of North Carolin or recive Stat und, plavso provide bie description of the nature of hat Busines, Known or with Which dus diligence coud reasonably be now. | Name of Nonprofit Corporation or Organization Describe State Business or State Funding 8. During 2017, were you, your spouse, or members of your immediate family a director, officer, or governing board ember of any Society, organza, or KvOKAGY Group Vi an Inrest In maters ver which your agency or Board may Rove forsicsant ves No [J Legisltor ici! Ofer - You are nc eure to complete this question you ar ling because Vo are a legato o judcal offer of You re ing 55 an appomiss to hase ofces. 00 ot Ist organizations of which you re nly a member (not serving i leadership oe). Name of Society, Organization Leadership postion or Advocacy Group (Director, Office, Board Member) The SEX and any attachments, excluding the Confidential Form, are public records. Page sof 10 «| 9(a). List 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, 2017. |__Nameofperson | RelstonshiptoFiler | Nameor Company | _Roleof person Io Business Assaciotons 9(b). If you know that any company or business 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, 2017, provide a Set desc of ha busines ath: Name of Company or Business Entity (Not applicable (No entities listed on #9a) 7 [U0ieadq) fon Dlog seeeiss | ad btsed_cid $n tole, | [ry Tr p——— | Tver to. Dons oars ome |] | If “Yes”, check each category of legal representation in which you or the law firm with which you are affiliated has eamed legal fees of more than $10,000 ding 2017. | Dnimimstatie Cindmiany Ocoee Ocminat Decedent's Estates Environmental insurance Cltabor J Local Government. [JReat Property securities OTax Tort litigation (including [0 utilities Regulation [0 Other category not listed. resigencs) 5. Duroa 201Zwere you 3 Wenead professional (oer Tan an storey) ar dH you prove consling services Incdialy of 5. martr of 8 professional as500aLo for Uhh yo ChOTSedo wert pad ovr $10,0007 ves Xno Type of Business The SEE and any attachments, excluding the Confidential Form, are public records. Page sof 10 12. Are you or your employer, your spouse or members of your immediate fami, or their employer curently: + Licensed by the State board or employing entity with which you are or will be associated or + Reculated by the tate board or employing entity with which you ae or will be assaciated or | Have busines ratonshia wth the State boar or employing entity with whch you ae or wil be assodaed? | DYes CIN Ctesisiatorpudicial Officer - You are no required to complete ths question if you are ilng because You are a leisator or a Judicial officer (Judicial ofiar 1 defined in the SEI Helptol Tos) or you are fing a5 an appointee to those offices. Name of Employer | Type of Relationship (applicable) (Licensing, Regulatory, Business) tf] | 13. Are You, your spouse or 8 member of your immediate family currently registered as a lobbyist or lobbyist principal, or Were you registered as such within the 12 months preceding your ling of tis form? | Oves Oo Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration OTHER DISCLOSURES 14. During any calendar quarter in 2017 (but ony the time period after you were appointed, employed or led or were nominated as 5 candidate) dd you « receive any "gf(s)" exceeding $200 pr quarter from a person or group of persons acting together, and + when both you and those person(s) were outside Noth Carolina at the time you accepted the f(s), and the GI) re gen under crcumtance tat wouk ed reasonable person to conc ta they wre given eoboying? Oves Oo 50 mot report ots given by members of your extended fay. Do no report gis that have previously been reported by you to the Department of the Secretary of State on the “Expense Report or Exempted Persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received [eer The SET and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 + 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, either direct or indirect, rns etsy ele tar Cache soreness grr or q fing 05 0 judicil officer appointee. # Do 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.” Date of Name and Address of Donor(s) Estimated Market sSenhe a 16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or ancther. a ee py — I | ove yo | 1f "Yes", list ali contributions you (NOT immediate family members) made during 2017 with a cumulative SY lh or ro (A fmt fay mer) made dries 207 ith deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value whatsoever.” TN — Hgho contribution(s) with a cumulative total of more than $1,000 he St an ary tachment, sci Content Frm, rpc cris. rassotio 17. Are you an ppeinte or prospectve appoint to: 5. the head of a principal state department (e.5. cabinet secretary) apponted by the Sovermrior 5. 5 North Corina Supreme Court Justice, our of Appeals, Superior o District Cour Sudaer or 3 member of ay of the following boars: + ABC Commission Consol Resour Commision |< State Bosra of Ecucaton ves “no | * State soard of ections | ~ Division of Employment Security It Wo" proceed to Environmental Management Commission Question 15. | + Industrial Commission | * Human Resources Commission Rules Review Commission * Board of Transporation © UNC Board of Governors * Utes Commission © wide Resources Commision _ 31 s0, wer you poled or are you beng considered or spporiment that | ves [ING DUblC postion by Council of Ske member? Counc of State members ae 5120 | if omq= proceed to eon 16. Gestion 18. «so, you must indicate whether during 2017 you (nt medics foly members) engaged in any of te following Scie with respec 0 or on behalf of he Canciate or cmplon commis of he. Counc of State member who Shponied ou 0 00 Pol poston: i. Collcted contrutions from multiple contrbutors, tack possession of sch rile contpuion, and ransiemed of GNATEd hose colecen Conrnsions to th candidate or ommisae? Contritons re dened in aueston 6. En Sr ST A Aa i Vluntered fo campaign elated acts, whch include, bt are nok med Lo. none banks even sStancs, mang, VASE, Survey, of any oh acy tht vans the crmpog of » congas? 16. Have you ever been convicted of elon for whi you have not received ater (1) a pardon of inacance: ar (an are of expiant regarding ha comvcions aves io Grtense State of Conviction 19. you aware of any iver normaton hat you bless may 954s te Stat Eis Commission i avisng you Conceming Your compan with the State Government Es ACT | ves Jo tye, please provide such tomaton below. | The SET and any attachments, excluding the Confidential Form, are public records. Pages or 10 + [arrrrmaTion Laff ht the information provided in this Statement of Eonar Interest and any tachment hereto ae re, complete and seca tote best of my Knowedge and ble. Lalo certify tha have mot transfered, and will ol transfer, any ase, intr, or property for the purpose of concealing it rom disclosure while retaining an equiable interes | underscand ha my Statement of Economic Interest and any ascents a supplements thereto (ithe exceion of the Confidential Form regarding Unemancipated Chien) are public recor. acknowledge that 1 hve read and derstand N.C.G.. 138A-26 regarding conceslin o lin to close material information and N.C.G:S. 138A-27 regarding providing fls information: § 138.26, Concealing or fling to disclose mstrisl information. A fling person who knowingly conceals or knowingly fis to disclose informtion that i required to be disclosed ona siatcment of cconamic ners under is Article sal be guly of 3 Cas 1 misdemeance and shal be subject to disciplinary action under GS. 138A45. § 13827. Penalty fo fle information. A filing person who provides ase information on a saement of economic interst a equied under his Article Knowing that th information fle i guilty of a Class H felony and shall be subject o disciplinary ackion under GS. 138A45. Ee oC ss [Spee Printed Name Submit SIGNED, ORIGINAL documents only. 00 not fox or email this form. The SEX and any attachments, excluding the Confidential Form, are public records. Page 100110