Bernice M. Pitt

.%., NORTH CAROLINA STATE ETHICS COMMISSION | ro emiics commission use ony in 3 2017 STATEMENT OF ECONOMIC INTEREST | Date Received 915-814-3600 www.ethicscommission.nc.gov | IN F071 71152 ‘THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL le. wii YOUR SEI FILING OBLIGATION | promniiod ~=ifite Supp. Sentoe____ By___ Supp. Received ate fe Preis [oppeame ___ Tutgsawome ___Tuaspges Jer | Me Peridee, [Wears [HF 1 2 Hee Home SF] [Work part Hime Heo Hone 4 STATE GOVERMENT JOB (Specty Agency) BOARD/COMMISSION (Lst complete name of ai State boards on which vou are serving or are being consisesed) /J] rr] Edy coo kA Aid Doak LEGISLATOR (Spectty House or Senate) Do other immediate family members reside in your household? Yes Oo hen used throughout this form, the term Immediate family incuces your spouse (unless legally separated). I iso includes members of your extended family (your and your spouse's niéren, grandchildren, parents, grandparents, 2nd | iiings, and tne spouses of each of those persons) who reside In your household: st the ul name of al adults and emancipated minors In your household, A minor is 8 cd under 16 years od. Minors are emancipated by marrage, enlistment in the US miltry, o court order for emancipation. Sateen ions | | I -Huamest fad 1B fi Hdl Qesepl to AH Fhushond Pree thule CED Kefa// fod The SEI and any attachments, excluding the Confidential Form, are public records. Page 1010 B.. List ONLY the Initials of all unemancipated minors n your Rousenold beam, A minor 1s a child under 16 yeas od Note: You must list the full name of each minor child on the Confidential Form available at the end of this document. INITIALS FOR EMPLOYER NATURE OF UNEMANCIPATED ‘usINESs MINORS PROPERTY INTERESTS 1. As of December 31, 2016, did you, your spouse, or members of your immediate family: A. Hove an ownership interest in North Carolin rai estate (Including your residence) with a market value of $10,000 or more? | Rres Owe | TT — 7 sel 10. w Benlice m joolo] Tar bore, NC] Edlact rakes, 8. Lease or rent real estate or personal property to or from the State of North Carolia with a market value of $16,000 or more? Ove fino | Name of Lessor Name of Lessee If Real Estate, Location | If Personal Property, | (Renter) by City & County Descrive 2. At any time during 2015 or 2016, did you, your spouse, or members of your immediate family sell to or buy from the | ‘State of North Carolina personal property with a market value of $10,000 or more? i | Oves gto [ mameofpurchsser | Wemeotsaer | Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page zor 10 3. As of December 31, 2016, 0d You, your spouse. or members of your Immediate famly own any of te following francia interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY. A. St0ck n 2 ybicly owned company? | ves Roo >D5 nal Ist ounershlp Interests Tn widely Fed Investment fund (ncuding Futsal ors, regulated Testa companies, or pension or deferred compensation plane) I: (1) the fund Is pUSHEly raced. or ke aves are sibel iver; ana (1) nether you to a Immediate fay member ars aa t corr the assets held 1 ne mk! ord | investment company, o pension or deferred compensation pan: [ owwrotmest | rulNameotcomosny (50 not uses cr smb 5. ns company or business? Ove hho I Owner of Stock Option Full Name of Company (Do not use a ticker symbel) | C. Interests 1.2 con-oublicy owned company or business ent (including Interest n soe propretaraps, partnersips, imied partnerships, Sint ventures, mited fabity companies, mted Tabi paces, and Gosely held omorations? Yves DINo- No." proceed to auestion 4. [ owerammees | Name of Company or apiness En 2 1) IF; VAT FL 7 Sepl 10 UH Dads, P A NEY) 2h fudre Co, Ty © (1): For each non-publicly owned company or business enti (the primary company) denied is ave 35 hove: plese st he names of any othr companies o busness enrles 1 heh ire py Seen owns secures or aulty Interests valued ot over Sta.000, ¥ kore: orPublicly Owned Company or Business Entity | Other Companies in which tha Primary Company the primary Company) Owns Security or Equity Tnterests | The SEE and any attachments, excluding the Confidential Form, are publi records Page 3 of 10 C1 Tyas re open a Sess ary Te 3 CE) shove aay meal ours Ee ee of wr Coy ep hrod 3 h Soe, owie e reno ay 4. As of December 31, 2016, were you, your spouse, or members of your immediate family the beneficiaries of 3 vested. trust with value of $10,000 or more that was created, established, or controlled by you? |] S. As of December 31, 2016, did you, your spouse, or members of your immediate family have liablilties of $10,000 or ‘more, excluding the mortgage on your primary personal residence? Examples Include credit card debts, auto loans, student nt Cres Ono Name of Debtor (You, Spouse, Immediate Family Type of Creditor (Commercial Bank, Credit Union, ; ies omen rey 7 ie - 4 © List cae saarce of Income (not speci amounts) of mare than 35.008 recevea by you, your spouse, or members of | Ee arene sesame | eras eso of hewn sind 4 raed 0 | Sorts Tn a oo at ntact cm rece rm th lowing sree: | japan pest aria relearn » ikay etroment Soca sunt Incoma/ 501 r——— peor pmprp— | Business /Industry Unsepl 16 1:1 ZEEE Build] Direct 2 1 =a 3 7 Ev WF 7 UF & ne, er re pe Demi hl ~3 gj 4 “ fetal Hers he SEE an any tachment, exciding the Coden Form, ar PUBIC records. J PROFESSIONAL AND CIVIC RELATIONSHIPS 743). Bung 2016, were you, your spouse or members of your immeslate family @ director, officer, governing board member, employee, independent contractor, or registered lobbyist of a hoNBTONt corporation organisation operating Is | re State of orth Carolina army or religous, charitable, Scent, Ierary, puple health and safe, o sucations) purposes? ves io wo,” proceed to questions. "D0 rit st State Boards or entitles, or entdes created by » povical SUbAiEion of the State, > Do not ist erganizations of which you are mare member. Name of Person His Mer position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization 760). Ifthe nonprofi corporations or organizations sted above do ousiness with the State of North Carolia or receive State funds please provide a brief description ofthe nature of that busines, If Known or with which due itgence costs reasonably be known ‘Name of Nonprofit Corporation or Organization Describe State Business or State Funding 0 one or ot known © Dua 20, i vou, _ SE or rer of your Immediate arly 3 rector, officer, a7 Governg Bo87d member of any Society, organization, r SGNOGRCY 910uP with on nterast n Mattar over whih your 39ure or board ony Rave Jursdcugn? You are a legisiator or 3 fulcia office or you are fing as an apeintee 1 oss Sees. 00 not lst organizations of which you are only 3 member (not serving In a leadership role). Name of Person Name of Society, Organization i Leadership Position or Advocacy Group |_(oirector, Officer, Board Member) The SET and any attachments, excluding the Confidantial Form, are public records. Page 5 of 10 { family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2016. Name of Porson | _Reiationship to Filer | __ Name of Company | __ Rate of person Josep I Martew Vi todd CEO | Jo segl 10 [Hushured Mgriow £42 ub] Se =D ‘business contracts with the State of North Carolina or was regulated oy the State 2s of December 31, 2016, provide 2. [Biot appictie (to entices sted on #5) rr 1 | 10. Are you a practicing attorney? 1 Des Hee Dudicial Offcer/State Attorney legal fees of more than $10,000 duriog 2016. ver te Foret see arses 12. Are you or your employer, your spouse or members of your immediate family, or thelr employer curently: | + Licensed by the State board or employing entity with which you are or will be associated or + Regulated by the State board or employing entity with which you are or will be associated or . i he State board or employing entity with which you are or wil be assodated? | Ove Oegistator/udical Officer - You are na required to complete tis question Ifyou are fing because you are a legsitor o a sudicel oficer (‘udicl officer a Gefined in the SEX Helofl Ts) o you are fing as an appointee to those ofces. ‘Name of Person Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) 13. Are you, your spouse or a member of your immegiate family currently registered as a lobbylst or lobbyist principal, or | were you rgistared 3s such within the 12 months arecadioa Your ng of i orm? Ores de Lobbyist’s Principal Date of | Registration Registration Expiration OTHER DISCLOSURES 13. During any calendar quarter in 2016 (5ut oly th time period fcr you were appointed, employed or led or were | Rominated as candidate, 0d you = 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 Carolin a th time you accepted th gif(s), and + the gifs) were iven under circumstances thet woud lead reasonable person to conclude that they were given for oooyiga” aves Ho 55 nak Tepor 9 Gen by members of your extended rly. 1 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.” } [remem Receives Name and Address of Donor(s) | Describe Item Received | Estimated Market | Value | The SEE and any attachments, excluding the Confidential Form, are public records. Page 7of 10 ves we cic Offer vou re nt rere t complete is asso fou ar il offer or you re 1 deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of valve shana | oe Tew Comes [ETT —————— ! 2 te ead of 2 principal ate department (5. abt secretary) Pad oY th 5. 3 Nort Carlin Supreme Court ste, Court of Appl, Superior a Drs Eb . 2 member of any of the following boards: hac Commission ~ Consol Resowens Commision ~ Soe bard of Edecaon Oves Te | ~ Stee Board of Slocions | vison of Employment secur 3 Wor process to] Cnvronmeratwanagemens Commission Testi 18. | nus Commision man Resor Commission Res Reon Common Sedat Tempore © INC sora of Governrs | ies Gamsan * Wide Resources Commision a 30, were you sponte or are vou beng corals tr apparent tat | ves OI Bo roa Br en of See me Coan 4 pe ema re 123 | eo cou to fred [ © Treo vou sk late hatter daring 2916 you (x mediate oly emis) engaged any of th having cues wih Tepe 1 ro belt anda ampai sori of th Coun of Sire marmot who Bk eh COvYes [No 1 Colles contuions om mull contr, nk easton f sch ie corioadane and aneres on dear Bats oheses one oth cs coms Covers te saned in ester 8; i. Hosted 3 fundraiser at your residence or place of business? OvYes [No Voir ty oper ed epee SH ei DUEL 1 Jupp dpi input ll [=O | har sony ik sevsnees te cal 5 et? 5 avs You evar bean cored of = elo or wich you ave ot reeves ars (33 parson of revere 7 7 | pire bert Ro Le | Oves a I oes [own orci | oun of cometion | seam ot corviion FE a ee fy wT ——— Corin vou omens wi oe ae Gove Si 0 | | ves Who yes, ease rovise such information bow. | he SEX ant any attachments, excluding the Confidential Form, ara publ records. —— AFFIRMATION | aff thot he information provided nis Salement of E<ogon crest and any achipens helo se tu, compte, 2d asa 0 he best of my owe and beliet. Yao ceri ht ave ot transferee, and will motos any ase, secs, propery forte purpose of concealing. | from disclosure while recaining an equiable interest | | understand that my Stsement of Econom ners and ay sschmens or supplements thereto (with he xcepion of te | Confidential Form tegarding Unemaneipaied Childe) sr pal record acknowledge hat have read and understand N.C.G.S. 138A-26 regarding coneling fain o disclose teil information tad N.C.GS. 138A-27 regarding providing fie formation: § 13826, Coneating o filing to disclose materi norton. | A Big psn bo noviagly nls x kuin ul che foo dts eid dics | on Stent of conor eres under is Asie shall be uy of 3 Cas 1 misdemeanor and shal be subst | isemestemme mete | $1382. Penalty or fle information. A Bling person who provides fs information on isement of economic frst as required nde is Asics mowing that oe information i ls is gully of Clas H ony aad sal be subject o discplry acon des GS 158A. Gly p DC , he paler — | Be pn + | | Fea ame | | submit stone, oRsGINAL documents only. 00 not tax or small his form. The Sex and any attachments, excluding the Confidential Form, are public records. Page 100110

Oh NORTH CAROLINA STATE ETHICS COMMISSION [xcs cus ot ou FA ate eceves 4] 2016 STATEMENT OF ECONOMIC INTEREST | NO CHANGE FORM ELE PR THIS ENTIRE FORM MUST BE COMPLETED TO | scones ae | nA via entered in 08 “ IA S| FILER'S NAME (FIRST, MIDDLE, LAST) | 1] refx Firs Middle n i ast Nam ix [pref Name | Middle Name Last Name | sutt tvs | Bernice Meas Lic | REASON FOR FILING (SELECT ALL THAT APPLY) _ oo ~ | CISTATE GOVERMENT 108 (ease spect the agency for | 3BOARD/COMMISSION (Please Is: complete nome of all | | which you work or are being considered) ‘State boards on which you are serving or are being 1 A | conse) J | [E100 G7 pn pct re ie | CASA eat mos Sei AFFRMATION — — = afr that (he information provided In thi Statement of Ecanomic Interest and any altachments hereto are tru, Complete, and accurate to the best of my knowiedge and bale. als certify that 1 have not transferred, and wil nat transfer any asset, Interest, or property fo the purpose of cancealing irom disclosure whe eLamag an sauiable inerest 1 understand tha 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 1 have rea and understand N.C.G.S. 138A-26 regarding concealing or failing to isciose material formation and N.C.6.5. 138A-27 regarding providing flse nformat an § 1384-26. Concealing or failing to disclose matenial information | | A fing person who knowingly canceals or ngiingly fails t discose information tht s required ta be disclosed on Uae of crane erat under tis Atle shal Be Guy of lots 1 misdemeanor and shal be subject to acipinery acon tinder G5. 136A 4 § 1384-27. Penalty for flse information. A fing persen wha provides false nformatin on statement of economic Interest as required under this Article Knowing that he nfarmatio 1 Tis 1 Gully of 3 C125 H felony and shall be sublect to disciplinary acion under GS. 1308.35. I hereby affirm that T have reviewed my mast recently filed 2015 Statement of Economic Interest and that as | of Decambr 31, 3015, my responses continue tbe true, correc, and complete tothe best of my knowledge and belier. A Ci Agree ) | [iF io) 4 IX 3)24%/ 1 Sgratwre oama— Bence MOF Printed Name Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. _ ] This entire document is a public record.

. Any,’ NORTH CAROLINA STATE ETHICS COMMISSION bf A) ep 2015 STATEMENT OF ECONOMIC INTEREST = NO CHANGE FORM (DERwce __MmeAds | P77 |_| REASON FOR FIUING (SELECT ALL THAT APPLY) = (Fee i Se | CI STATE GOVERNMENT JOB, (Please specify the agency for | [/BOARD/COMMISSION (please st sompiets name of HE which you work or are being considered) 5 | "State boards on which You Ta S8IVIng OF are belng UREN NC J : D6ECompE Commu) HUGE CI UDICIAL OFFICER (Please spect the office you hold) _| CJ LEGISLATOR (Fieaso spel Rouse of Senate) dibnanaeetsy| Coffin tht the Information provided n this Statement of Economic Interest and any atachments hereto ae tru, Compe, and acura 1 th st of my knowledge and bor. also certify that 1 hve not transfered, and il nt ranste, any asset, interes, or property for the purpose of concealing irom declosure whl retaiing an equitable teres. understand that my Statement of Economic Interest and any attachments o supplements thereto (with th exception of he Content Fort rgoroing Unemanciped Chien) ar Subl econ 1 acknowledse that 1 hove read and understand N.C.G.5. 138A-26 regacing concealing o fain to disclose material formation and N.C.G 5. 138A-27 regarding providing fis information 5 1354-26. Concealing or fing to disciose material information. A fling person who knowingly conceals or knowingly 8 to disciose information that srequled to be disclosed an mere ol economic meres under this Avice shall 56 uly of a Coss 1 misdemeanor and shal be subject to Siepinary scion uncer G.5. 130-45. § 1308-27. Penaty fo ais information. A fling person who provides alse Information an statement of economic neres a required under tis Arie Knowing tho the ofrmation fos 5 Gully of 5 Cass felony and snl be subject to dscpinary acon under Ss! onss. I hereby affirm that I have reviewed my most recently filed 2014 Statement of Economic Interest and that as STDs 33. Bots my respons arin 1 be ue ore and complet oth st of my knowledge and beter, eff nares 8) KE MEALS {12 02/05/45 7 ented Nome Yi Bre 7) e ean 77 submit SIGNED, ORIGINAL documents only. Hp lA Do not fax or email this form. | Signature | “This entire document is public record.