Beth O. Friedrich

ZN FoR ST bat oNY. 1 V1 1 GED STATE ETHICS COMMISSION Doe Receed (Alags) a 9 EP J) 2019 STATEMENT OF ECONOMIC INTEREST == NO-CHANGE FORM rec ra hs This entire form must be completed to fulfill your sames 45 _ one l1119 ethics filing obligation. crerec 05 by Fler's Nome (Fst, Middle, Last) Reason for Filng (Complete all tht appt. State Government Job (Speci agency and positon.) | Boara/ Commission (List the complete names of all State CR wr Judicial Oe (Spec office.) Legistator (Specfy House or Senate.) AFFIRMATION The information provided i tis Statement of Economic Interest and any attachments are true, complete, and accurate to the best of my knowledge and belle. 1 have not transferred, and wil not transfer, any asset, interest, or property for the purpose of concealing i from disclosure hie retaining an equitabe interes understand that my Statement of Economic Interest and any attachments except or the Confidential Form Regarding Unemancipated Children public records. have read and understand the following statues: N.C.G5. § 1638-191, Concealing or failing to disclose material information. A fing person who knowingly conceals or knowingly fal to disclose information that is required to be disclosed on a statement of economic intrest... hall Bo guity of 3 Class 1 mademeanor and. subject o disciplinary action Under G5. 1638415. N.C.G.S.§ 1634192. Penaty or fase information A fling person who provides flse information on a statement of economic interest... Knowing that the information is folse 1s Quit of a Clas H felony and shal be subject o Gscpinary action under 5, 1634-415. Taffirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue to be true, correct, and complete fo the best of my knowledge and belief. 1 affirm under penalty of perjury that the foregoing is true and correct. TT — Bate Printed Name Submit signed, orginal documents only. Do not fax or e-mail this form. J This entire document is a public record.

ZN FoR ST bat oNY. 1 V1 1 GED STATE ETHICS COMMISSION Doe Receed (Alags) a 9 EP J) 2019 STATEMENT OF ECONOMIC INTEREST == NO-CHANGE FORM rec ra hs This entire form must be completed to fulfill your sames 45 _ one l1119 ethics filing obligation. crerec 05 by Fler's Nome (Fst, Middle, Last) Reason for Filng (Complete all tht appt. State Government Job (Speci agency and positon.) | Boara/ Commission (List the complete names of all State CR wr Judicial Oe (Spec office.) Legistator (Specfy House or Senate.) AFFIRMATION The information provided i tis Statement of Economic Interest and any attachments are true, complete, and accurate to the best of my knowledge and belle. 1 have not transferred, and wil not transfer, any asset, interest, or property for the purpose of concealing i from disclosure hie retaining an equitabe interes understand that my Statement of Economic Interest and any attachments except or the Confidential Form Regarding Unemancipated Children public records. have read and understand the following statues: N.C.G5. § 1638-191, Concealing or failing to disclose material information. A fing person who knowingly conceals or knowingly fal to disclose information that is required to be disclosed on a statement of economic intrest... hall Bo guity of 3 Class 1 mademeanor and. subject o disciplinary action Under G5. 1638415. N.C.G.S.§ 1634192. Penaty or fase information A fling person who provides flse information on a statement of economic interest... Knowing that the information is folse 1s Quit of a Clas H felony and shal be subject o Gscpinary action under 5, 1634-415. Taffirm that I have reviewed my most recently filed 2018 Statement of Economic Interest and that as of December 31, 2018, my responses continue to be true, correct, and complete fo the best of my knowledge and belief. 1 affirm under penalty of perjury that the foregoing is true and correct. TT — Bate Printed Name Submit signed, orginal documents only. Do not fax or e-mail this form. J This entire document is a public record.

CL ., #7#%+ NORTH CAROLINA STATE BOARD OF || For coupLiance unrr use ony iR"};; ELECTIONS AND ETHICS ENFORCEMENT Date Received: V2 2018 STATEMENT OF ECONOMIC INTEREST | 919-814-3600 www.ncsbe.gov/Ethics/SEI __ Checked for completion THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL | -£25omestS 1 owe YOUR SEI FILING OBLIGATION Incomplete 7s Supp. Sentome oy Supp. Received Date _____ Entered in database oy ___ FILER'S NAME (FIRST, MIDDLE, LAST) | Bet | Jaw FRE EDEL [1] [omoromom —— lopwme REASON FOR FILING (COMPLETE ALL THAT APPLY) Fe st boars an which you are serving or are being considered) HE Desop Camarie I 0 0 pooh 6 A. Do other immediate famity members reside in your household? XE Ome When ised throughout this form, the term Znenediate taal inches your spouse (unless legally seperated). Tt aso cudes: members of your extended family (your and your spouse's chidren, grandchidren, parents, grandparents, sd Sibings, ond the spouses of each of hase persons) who reside In your howard, Minors are emancipated by marriage, enitment in the US mitary, or court order for emancipation. FULL NAME OF ADULTS & | RELATIONSHIP | ewmoven | 308 TITLE NATURE OF EMANCIPATED MINORS BUSINESS TT | — The SET and any attachments, excluding the Confidential Form, are public records. Page1of10 B. Lit ONLY the intias of ail unemancipoted minors i your househod bow, A minor 2 rid under 18 years od. Note: You must list the full name of each minor child on the Confidential Form available at the ‘end of this document. INTIAS FOR | ReLATIONSHIP EMPLOYER Sos ITE NATURE OF UNEMANCIPATED ‘BUSINESS MINORS DE + p! rd = - I EE i ~ I [1] PROPERTY INTERESTS 1. As of December 31, 2017, did you, your spouse, or members. of your immediate family: A. Have an ownership interest in North Corot rea stats (chain your residence) wih 2 market va of $10,000 or more? Be One £ Priedm— 0 Zo 2 | Ocha | rr TN 8. Lease or rent real estate or personal property to of from the State of North Carolina with a market value of $10,000 or re? OYes Kgflo Name of Lessor Name of Lessee | 1f Real Estate, Location | if personal Property, (Renter) by City & County eseribe 2. At any time during 2016 oc 2017, did you, your spouse, or members of your immediate fomity sell to or buy from the ‘State of North Carolina personal property with a market value of $10,000 or more? Ove flo Name of Purchaser Name of Seller Type of Property The SEI and any attachments, excluding the Confidential Form, are pubic records. Pagezor10 _______________ FINANCIAL INTERESTS 3. As of December 21. 2017, did you, your spouse, or members of your immediats family own any of the folowing financial interests valued 3t $10,000 or more? LIST EACH COMPANY INDIVIDUALLY. A. Stack in 2 publicly owned company? Ove fo D0 0a Ist Owhership interests Tn a widely hold investment fund (nding mutual funds, reguisted Investment ‘companies, or pension or deferred compensation plone) : (1) the fund s publicly traded or 5 assets are widely diversified; and (1) neither you nor an imimedite family member are abi t CITI the assets eld In Se mutual fn 5. Stock Ontions in a company or business? ove fo vas of omy oo kr ym) C. Interests in 2 non-public armed company or business ent (inckuding interests in sole proprictorsips, | portnersius, Bmited partnerships, ork ventures, ited kabiity companies, Bid EabaRy partrersias, and Gosely held corporations)? DYes Fo - 11"No,” proceed to question 4. | ownerofimerst | Name of Company orBusinesstntty | € (4). For each non-publicy owned company or business entity (the “primary company”) identied in question 3.C_above, please is the names of any other companies or business entities in which the primary company owns securities or equi interests voked at over $10,000, # known. Non-Publicly Owned Company or Business Entity | _ Other Companies in which the Primary Company (the Primary Company) ‘Owns Security or Equity Interests None or Not Known The SEX and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 (2). If you know that any company or business entky fisted in 3.C or 3.C(1) above has any materi business eslings or business contracts with the State of North Carolina, or i regulated by the State, provide 3 brief description of that business activity. Name of Company or Business Entity Description of Business Activity with the State {1 None or Not Known 4. As of December 31, 2017, were you, your spouse, or members of your immediate family the beneficiaries of a vested rust with a value of $10,000 o more that was created, established, or controgied bY ou? Do not ist assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” Ove [ho RRC rr TY TT rr ETT | 1] | 5. As of December 31, 2017, did you, your spouse, or members of your immediate foriy have kabilties of $10,000 or more, exchuding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student loans, personal loans and intra-family debt. Ries On Name of Debtor (You, Spouse, Immediate Family Type of Creditor (Commercial Bank, Credit Union, Member) } Individual, etc.) Pe Frieda a Coan 6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your immediate family during 2017. Indude salary, wages, state/local govemnment retirement, professional fees, ‘honoraria, interest, dividends, rental income, business income, and other types of income required to be reported on your State and federal tax returms. Do nat incite income received from the following sources: > Capital gaina > Federal government retirement > Military retirement > Social security income/SSD Business/ Industry 1nd no reportable income over $5,000 in 2017. BAL Ficka 0a Garr, Anil ox fF] | I] The SEX and any attachments, excluding the Confidential Form, are public records. Pagesor1o ES — PROFESSIONAL AND CIVIC RELATIONSHIPS 7(2). During. 2017, were you, your spouse or 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 the State of North Carolina primarily for religious, charitable, scientific, iterary, public health and safety, or educational purposes? Oes Ro - If "No," proceed to question 8. » Do nat ist State boards or entities, or entities created by a political subdivision of the State. > Do not lst organizations of which you are a mere member. Name of Person | Mis/Her position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization Z(b). If the nonprofit corporations or organizations listed above do business with the State of North Carolina or receive. ‘State funds, please provide a brief description of the nature of that business, I known or with which due diligence could reasonably be known. Name of Nonprofit Corporation or Organization Describe State Business or State Funding CJ None or Not Known 8. During 2017, were you, your Spouse, or members of your inmediate 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? Oves. fo J Legisiator/ Judicial Officer - You are not required to complete this question if you are filing because. You are a legisiator or a judicial officer or you are filing as an appointee to those offices. Do not fist organizations of which you are only a member (not serving in a leadership role). Name of Person Name of Society, Organization Leadership Position or Advocacy Group (Director, Officer, Board Member) The SET and any attachments, excluding the Confidential Form, are public records. Page 5 of 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. [Name of person | Relations to Fler | Name of Company Rote of person go Business Associations 50). 1 you know hat or company o bine erty fed n 3) ave 1d ary ter ines desing business contracts with the State of North Carolina or was regulated by the State as of December 31, 2017, provide a oe dio of kt is se, Name of Company or Business Entity Description of Business Activity with the State (Gt solcabie (No nies ted on £99 [0 ous oc stomer? Jyres [OMe [Judicial Officer/State Attorney 1 ~Ve', check each catagory of gal representation i wich yuo hf rs wih ich yu are afte hs eared legal fees of more than $10,000 during 2017. CJ Administrative [J Admiralty [0 Corporate J Criminal [0] Decedent's Estates. J Environmental [Insurance 0 tabor [J Local Government: [J Real Property [J Securities Tax (0 Tort litigation (including [0 utilities Regulation [0 Other category not listed. pout 1. During Z007.were you 3 emnead professional (oer an an sfomey) or 99 you prove coring rvs Inia or 3 memes of profesor moon tr Hh Yo harp oe wes po seo Oves Seto Type of Business Nature of Services Rendered The SEL and any attachments, excluding the Confidential Form, ar public records. Pagecorio 12. Are you or your employer, your spouse or members of your immediate family, or their employer currently: Pr a * Regulated by the State board or employing entity with which you are or wil be associated or : seis sw pant ct? Oves No 0] Legisiator/Judicial Officer - You are not required to complete this question If you are filing because. TR de Se Sore me nes Ry Len” HE 1 13. Are you, your spouse or a member of your immediate famity currently registered a5 a lobbyist or lobbylst principal, or were you registered as such within the 12 months preceding your filing of this form? Oves Xho | Registration Expiration I Pe a Sk eS nominated as a candidate), did 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 Carolina at the time you accepted the gii(s), and ER me nT EE Et eR re eo rr eno nn | | LL J rr 1 15. During 2017 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) aid you + accept a “scholarship” exceeding $200 from a person or group of persons acting together andl « those person(s) were outside North Carolia andl = the scholarship was elated to your public positon? A “scholarship” is a grant Jn-ai, either direct or indirect, tn attend 2 conference, meeting, or similar event, Inching tution, travel, lodging, meas, and other simbar expenses. Dey C3 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 nck report gifs that have previously been reparted by You t the Department of the Secretary of Sta on the “Expense Report for Exempted Persons.” > Legisiators are nok required to report scholarships paid by a nonpartisan legisative organization of which the legisator or the General Assembly fs 8 member or participant or an aTkate of that organization. I Date of Name and Address of Donor(s) Describe Event Estimated Market Scholarship Value 16. Were you appointed or are you being considered for an appointment ta covered board by the Governor or another Counc of State member? Council of State members are: > Govemor » Lt. Governor > Secretary of State » State Auditor > State Treasurer > Superintendent of Public Instruction > Attomey General » Commissioner of Agriature ~~ »- Commissioner of Labor > Commissioner of Insurance Ove Xho If “Yes”, Nat all contributions you (NOT immediate family members) made during 2017 with a cumulative total of more than $1,000 t the Governor or other Council of State member who appointed you. Contributions are defined in N.C.G.5. 163-278.6(6) and incude, but are not imited to, “any advance, conveyance, epost, dtzukion, transfer offs, loan, payment, Gf, pledge or Subscription of money or MENG of vale: whatsoever.” Date Amount Contributed to [J No contribution(s) with a cumulative total of more than $1,000 The SEI and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 17. Are you an appointee or prospective appointee tor a. the head of a principal state department (.9. cabinet secretary) appointed by the Governor; or 5. 3 North Carolina Supreme Court Jusic, Court of Appeals, Superir or District Court Judge; or . a member of any of the following boards: + ABC Commission + Coastal Resources Commission + State Board of Education Oves [fio + State Board of Elections + Divison of Employment Security If “Nos proceed to + Environmental Management Commission question 18. + Industrial Commission + Human Resources Commission + Rules Review Commission + Board of Transportation | + UNC Board o Governors «+ Utities Commission + Widife Resources Commission 20 were you appones rae. you being conser fo span ort | Ces (je public postion by a Council of State member? Counc of State members are 15124 | 11 oo,” proceed to I auesnan 16. one 18. e. 1 so, you must indicate whether during 2017 you (not immediate family members) engaged in any of th following activites with respec to or on behalf of the candidate or campaign committee of the Counc of State member who appointed you to your public position Oves fpo i. Collected contributions from mule contributors, took possession of such multiple contributions, and transferred or delvered those collected Contributions to the candidate or committee? Contributions are defined in Question 16. i. Hosted a fundraiser at your residence or place of business? Oves Xfo i. Volunteered for campaign-relted activities, which include, but are not limited 1c, hone barks, vent sssatace, mang, comuasang. urvenig, ar amy | 1Yes rita other activity thet advances the campaign of a candidate? 18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon of innocence; or () an ‘order of expungement regarding that conviction? Ove Kft ones one tcomteton | Gouny ot conietion | ste ot conieion | 19. Are you aware of any othr information that you befieve may assist the State Ethics Commission n advising you conceming your complonce with the State Goverment Ethics ACT Dies [flo If yes, lease provide such information below. -— 0 1] The SET and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 AFFIRMATION Vaffirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and sceurate othe best of my Knowledge and ble. Yas certify that have not transfered, nd will o transfer, any ast, intrest, or property fo the purpose of concealing i fiom disclosure while reaming am equiabe meret. 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of the. Confidential Form regarding Unemaneipated Children) re ble recor Y acknowledge tha ave read and understand N.C.G., 138-26 regarding concalng or fing to disclose material information and N.C.G.S. 138427 regarding providing fle information: § 138A-26. Concealing or failing to disclose material information. A ling person who knowingly concess or knowingly ist disclose information that s required t be disclosed ona statement of cconomic intrest under his Aricic shal be guilty of a Class 1 misdemeanor nd shall be subject To disciplinary action under GS. 1354-45 § 138A-27. Penalty for false information. A ling person who provides ls information ona statement of economic interest s round unde tis Article knowing that the information is false is guilty of a Class H felony and shall be subject to. disciplinary action under GS. 138A A Holaur Fe = Ea A. Miedn'the Printed Name Submit SIGNED, ORIGINAL documents only. D0 not fax or emai this form. The SEI and any attachments, excluding the Confidential Form, are public records. Page 100110

, NORTH CAROLINA STATE ETHICS COMMISSION FOR ETHICS COMMISSION USE ONLY § jj. 3017 STATEMENT OF ECONOMIC INTEREST De Receed 919-814-3600 www exhicscommission.nc.gov mis -2 #2 THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL | "1% ow” fio ~ YOUR SEI FILING OBLIGATION 2 seamed Gf Tome Supp. Sent ote o Sump. Pecewed Ome nes ons ANT AC [Fs wa mer, mo, - Prefix | First Name Middle Name Last Name [sure ™ - A Eos — rs] Sekt, | fel ode CURRENT EMPLOYER _ B Jos rime Ae Depertmes of Commene | Leah, Ctagel. Covnsed [ravre os re or usiness 7 . } | Crane. Developpent— I SE REASON FOR FILING (COMPLETE ALL THAT APPLY) STATE GOVERNMENT JOB (Specify Agency) [ BOARD/COMMISSION (List complete name of all State ? Boards on which you sre serving or are being considered Tot of Comins Co — Te err — — A. Da other immediate family members reside in your household? | Des Ute ‘When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also Inciods members of your extended amy (your and your spouse's Chdren. orandehidren, parents, grandparents, and Slings, and the spouses of each of those persons) who reside In your household. List the full name of al adults and emancipated minors in your household. A mina is hid under 18 years old. | Minors re emancipate by mariage, ensiment in te US milary, or cour order or emancpaten. FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER | J08 TITLE NATURE OF EMANCIPATED MINORS. | 1 NE: + Fd lonil | LIell Spe | Marth becom. E52 (Cre Frefsee | hated |LllSpet | Murkeby beset - _— _ — lL The SEX and any attachments, excluding the Confidential Form, are public records. Page 1f 10 1B. List ONLY the initials of ail unemancipated minors in your household below. A minor is a hid under 18 years old. | Note: You must list the full name of each minor child on the Confidential Form available at the |end of this document. eam— INITIALS FOR | RELATIONSHIP EMPLOYER 308 TITLE NATUREOF | | UNEMANCIPATED BUSINESS i MINORS | | - = EE A | f : | PROPERTY INTERESTS i 1. As of December 31, 2016, did you, your spouse, or members of your immediate family: A. Have an ownership interest in North Carolina real estate (including your residence) with a market value of 510,000 or more? ves [Ito Owner of Real Estate | % Ownership Interest | Location by City | Locatio wher of Real Estate wnership Interest | Location by City Location by County T Red Triutm — wh | Gn Lode | ; nee g J | romal Thre | ovr | Cory [BY | [ i - i L SE I SS B. Lease or rent real estate or persanal property 10 or rom the State of North Carolina with a market value of $10,000 or more? Cives [Fo Name of Lessor Name of Lessee | If Real Estate, Location | If Personal Property, oo (Renter) by City & County Describe 2. At any time during 2015 or 2016, did you, your spouse, or members of your immediate family sell tor buy from the | State of Nath Carolina persanal property with a market value of $10,000 or more? Yes ore Name of Purchaser Name of Seller | Type of Property i The SEI and any attachments, excluding the Confidential Form, are public records. Page 201 10 FINANCIAL INTERESTS 3. As of December 31. 2016, di you, your spouse, ar members of your immediate family own any ofthe following financial interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY. A. Stock in a publicly owned company? Oves Sve _ __ Do mot list ownership imerests in a widely eid investment fund (including mutual funds, regulated investment companies, or pension or deferred compensation plans) If: (i) the fund is publicly traded or its assets are widely | versie; and (1) nther you or an immediate family member ore able to Control the assets held In the mutual fund, | investment company. o pension or deferred compensation pian Owner of Interest Full Name of Company (Da not use a ticker symbol) | . Stock Options in 2 company or business? Cives ON Owner of Stock Option Full Name of Company (Da not use a ticker symbol) 1 T a ———— ER. 1 C. Interests in a non-publicly owned company or business entity (Including interests in sole proprietorships, partnerships, Imited partnerships. int ventures, limited labity companies, Imied 1aDity partnerships, and Close meld corporations)? [Yes [No If "No," proceed to question 4 | Owner of Interest 1 Name of Company or Business Entity | SE EE — € (1). For each non publicly owned company or business entity (the “primary company”) identified in question | 5. above, please Ist the names of any other companies or business entities in which the primary company ns secures or equity interests vatued at over $10,000, known. " Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the Primary Company) Owns Security or Equity Interests FT Ap— I I The SET and any attachments, excluding the Confidential Farm, are public records. Page 30f 10 [ © (2). 1 you know that any company or business entity listed in 3.C or 3.C(1) above has any material business eng o business contracts with the State of North Carolina or is regulated by the State, provide a brief descnption of that business actty. ” Name of Company or Business Entity | Description of Business Activity with the state | [vane or Not Known | ou - | | L As of December 31, 2016, were you, your spouse, or members of your immediate family the beneficiaries of a = ust with a vaio 6 $10,300 o mare that was created, established, or controled by you? 0 not lst assets held in bin trusts. Se 2017 SEL Heltul Tis for the definition of Vested Trust” and "Bind Trust” | Oves [No Nome and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2016, did you, your spouse, or members of your immediate family have liabilities of $10,000 or| ore Sxcing the MONG99¢ on your rimary persona residence? Examples nude credit card debts, auto loans, Student Toane, porsanal loans and intra family debt. Fives [IN Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Viember) Individual, etc) |” Be Trcdmr= Sher lees 6. List each source of income (not specific amounts) of more than $5,000 received by You, Your spouse, or members of your immediate family during 2016. Include salary, wages, state/local government retirement, professional fees, Remora, mares. andends, rental come, business income, and other pes of Income require tobe reported on your State and federal ox returns. Do of includs income received from the following sources: | » Capital gains » Federal government retirement > Miltary retirement > Social security income/SSD Recipient of Income Name of Source Type of Type of Income Blsiness/ Industry | £11 had no reportable income aver $5,000 in 2016. — S30 aT a . <i oo — < [Erie Triedicrt Satan (ls Shek Gaeomi| Sdry (orate utin= | Set les | pend Sel S | | J | — EE a | i. - 1 — _ ] The SEX and any attachments, excluding the Confidential Form, are public records. Page 4 of 10 PROFESSIONAL AND CIVIC RELATIONSHIPS 7(a). During 2016, were you, your spouse or members of your Immediate family a director, officer, governing board member, employee, independent contractor, or registered obbyist of a nonprofit corporation or organization operating in The State of Noh Carolina primaniy for religious, chantable, scientific, terary, public health and safety, or educational purposes” [Ives (HG - It “No,” proceed to question 6. + 00 not st State boards or entities, or entities created by 3 political subdivision of the State. | > Da not st organizations of which you are a mere member. . . . Name of Person Mis Her Position Name of Nonprofit Nature of Business or | Corporation or Organization Purpose of Organization r - Nr — Batis deganization | Putysy ation | — — 1 — —T a 1 SE thh}E—~— _ — LL — 7(b). If the nanprofit corporations or organizations listed above do business with the State of North Caroling or receive State funds, please provkle a brief description of the nature of that business, If known or with which due diligence could reasonably be known ‘Name of Nonprofit Corporation or Organization Describe State Business or State Funding L — - . S— — _— | [Burin 2005, were vou. vor spouse, members of ye immadate arly 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? [Ives (380 []Legislator/ucicial Officer - You ar: not required to complete this question If you are fing because | Jou are legisiator or 3 Judicial officer or you are fling as an appointee to those offices. L 0 a Ss, | Name of Person Name of Society, Organization | Leadership Position | or Advocacy Group | (irector, Officer, Board Member) - i SE — . - — The SET and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 5a). 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, 2016. | Name of Person Relationship to Fler Name of Company Role of Person siness Associations | 1 TT i | 1 T | a | —— 1 — : a | (5). If you know that any company or business entity sted in (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, 2016, provide a bref description of tht business act. Name of Company or Business Entity Description of Business Activity with the State [Not applicable (Ko entities sted an £92) { hi Qin enter Bote EE EE 10. Are you a practicing attorney? 1 ~ [Yes [No [Judicial Officer/State Attorney | 11Yes", check each category of legal representation in which you or the law firm with which you ar affiiated has earned legal fees of more than $10,000 during 2016. CJ dministrative )agmratty CJ Corporate Cl crmnal [Decedent's Estates [Environmental Otnsurance tavor [Local Government Real Property [1 Secunties Tex Tort tigation (including Unites Regulation other category nat sted. negligence) a : | 11. During 2016, were you a licensed professional (other than an attorney) or did you provide consulting services individually or 25 8 member of 3 professions assaciation for Which You charged of were paid over $10,000 Oves (346 Type of Business Nature of Services Rendered | | Tvpeorusiness | sc The SEL and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 | 12. Are you or your employer, your spouse or members of your immediate family, or ther employer currently: + 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 o will be associated or = Have a business relationship with the State board or employing entity with which you are or will be associated? (Ives [No []Legisiator/Judicial Officer - You are not required to complete this question i you are fing because ‘You are a legisiator or a judicial officer (Juicil oficer” 1s defined in the SEI Helpful Tos) or you Bre fing 25 an appointee to those offices "Name of Person Name of Employer Type of Relationship (it applicable) winsing Reguttory, Business) | coe mm———r———— ———— — 13. Are you your spouse or a 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 filing of this form? Oves EiNo prevprrera [ITN or TOR verry Registration Expiration - — i. 1 1 - | OTHER DISCLOSURES _ _ _ oo 14. During any calendar quarter in 2016 (but only the time period ater you were appointed, employed or led ar were nominated as candidate), di you i + receive any "gift(s)" exceeding $200 per quarter from a person or group of persons acting together, and + when both you and those person(s) were outside North Carolina at the time you accepted the gis), and | + the gi(s) were given under circumstances that would lead a reasonable person to conclude that they were aiven for lobbying? Oves No Do not report gifts given by members of your extended famity. | »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 Item Received | Name and Address of Donor(s) Describe Item Received Estimated Market Value | | E— SS SS EE The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2016 (but only the time period after you were appointed, employed, or fled or were nominated as a candidate) did you | |» accept a scholarship” exceeding $200 rom a person o Group of persons acing together and | + those person(s) were outside Narth Caralina and | + the scholarship was related to your public position? A “scholarship” is a grant-in-aid, either direct or indirect, to attend a conference, meeting, o similar event, including tuition, travel, lodging, meals, and other similar expenses. [Yes [SN [Judicial Officer - You are not required to complete this question if you are a judicial officer or you are filing as 2 Judicial officer appointee. i Mam ajddaoferagpontes ee > Do not report gifs that have previously been reported by You to the Department of the Secretary af State on the “Expense Report for Exempted Persons.” i > Legisiators are not required to report scholarships paid by a nonpartisan legislative organization of which the legisiator | or the General Assembly 's a member or participant or an affiliate of that organization. oP Ea ETE Er — Err—— oateor ‘Name and Address of Donor(s) Describe Event Estimated Market | scholarship Valve | Scholarstip | SE | — 1 | I | — _ 1 SU _ | 15. Were you appointed or are you being considered for an appointment 10.8 covered boord by the Governor or anther Council of State member? | oer mare se | » Governor » Lt. Governor > Secretary of State » State Auditor » State Treasurer > Superintendent of Public Instruction > Attomey General » Commissioner of Agriculture » Commissioner of Labor » Commissioner of Insurance | Ove Dw 1f "Yes®, lst all contributions you (NOT immediate family members) made during 2016 with a cumulative total of more than $1,000 to the Governor or other Council of State member who appointed you. > Contributions are defined in N.C.G.S. 163-278.6(6) and include, but are not limited to, any advance, conveyance, epost, distribution, transfer of funds, loan, payment, Gi, pledge or subscription of money o anything of value. | whatsoever.” Date ] Amount T Contributed to ~ [546 contribution(s) with a cumulative total of mare than $1,000 1 The SEX and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 17. Are you an appointee or prospective appointee to: ] PI pp p—r—r— Govern; or ! 5. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District | Court udge: or | c. a member of any of the folowing boarcs: + ABC Commission + Coastal Resaurces Commission State Board of Ecucation Clves Emo © State Board of Elections Ii « Division of Employment Security If “No” proceed to + Environmental Management Commission auestion 18. | + Industrial Commission | © Human Resources Commission + Rules Review Commission + Board of Transportation © URC Board of Governors + bites Commision i © Wide Resources Commission BN | 4. 1 50, were you appointed or re you beng considered for appormtment to that | [Yes [No public postion by & Council of Sate member? Counc of State members re Id |r ong" proceed to n auestan 16. question 18. e130, you must indicate whether during 2016 you (not immediate family members) engaged in any of the following aCtVIIES with aspect to of on bea of he candidate or campaign committee of the Counc of State member who appointed you to your publi postion | Cves Tne i. Collected contributions from mulipe contrisutars, took possession of such | | multiple contributions, and transferred or delivered tose collected Contributions to the candidate or committee? Contributions are defined in | Question 16 " i. Hosted a fundraiser at your residence or place of business? CiYes [ino i. Volunteeres for campaign-reated activities, which include, but are not limited 15, phone Banks. event ass stance, malings, canvassing, surveying, or any | ClYes (ING other activity (hat 36vances the campaign o a candidate” 18. Have you ever been convicted of a felony for which you have not received either: (i) a pardon of innocence; or (1) an erder of expungement regarding that conviction? | Dyes [=o offense Date of Conviction | County of Conviction State of Conviction | Erarer———— —— 19. Are you aware of an other information that you believe may assist the State Ethics Commission in advising you concerning your compliance with the State Government Ethics Act? Dives > e If yes, please provide such information below. SE oo EE _— I The SEX and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 AFFIRMATION Laffirm that the information provided in this Statement of Economic Interest and any attachments hereto are true. complete, and accurate tothe best of my knowledge and belief also conti that 1 have not transfered, and il mot transfer, any ase, interest of propesty or the purpose of concealing if from disclosure while retaining an equitable interest. understand that my Statement of Economic Interest and any attachments or supplements thereto with th exception of the | Confidential Form regarding Unemancipatd Children) are public record acknowledge that have read and understand N.C 6.5. 138-26 regarding concealing or failing fo disclose material information and N.C.G 8. 1384-27 regarding providing false information § 1384.26. Concealing or fling to disclose material information A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed {o disciplinary action under G.5. 138A-45 § 138427. Penalty for alse information Knowing tha the information s false i ily of a Class 1 felony and shal be subit to disciplinary action under GS. 1383A45. ETagree_~ Pa a 2/5102 Fry Bare Det. A Pdi Printed Name | Submit SIGNED, ORIGINAL documents only. Donotfaxoremaitthistorm. The SET and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

Pras NORTH CAROLINA STATE ETHICS COMMISSION | FOR ETHICS COMMISSION USE ONLY w 4g 2016 STATEMENT OF ECONOMIC INTEREST Date Recelved: 919-614-3600 worm ethicscommission.nc.gov p11 mo 18 oo pation THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL cone oie YOUR SEI FILING OBLIGATION po . pl meonplen rs Su. ent Doe w_ Sur ceed owe Entered in database 1|26_ By BC FILER’ NAME (FIRST, MIDDLE, LAST) ] First Name Middle Name Tost Name Sutt_ ms. "Rene | ADA OPEV. [ cunent evpioven Jos Tme NATURE OR TYPE OF BUSINESS - REASON FOR FILING (SELECT ALL THAT APPLY) [BRETATE GOVERNMENT JOB (Please specify the agency [[) BOARD/COMMISSION (Please list complete name of all for which you work or are being considered) ‘State boards on which you are serving or are being. Concdered pene bmi Commerce, “Ladudped Comms Sdn. [J JUDICIAL OFFICER (Please specify the office you hold) | [J LEGISLATOR (Please specify House or Senate) A. Do other Immediate Family members reside in your household? DOYes o Wine usadoughout tis form, the term Immediate Family includes your spouse (unless legal separate). I iso en of yout scenic om (your an your o's hier, arandchlen, parents, Grandparents, ond tne Spat o ca of hose persons whe reside 1 your household. List the full name of all adults and emancipated minors in your household. A minor is a child under 18 years old. ars ar amamcpote oy marrage, eniStment nthe US Miltary or court order fo emancipation |FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER Jos TITLE NATURE OF EMANCIPATED MINORS | " SUsiness The SEE and any attachments, excluding the Confidential Form, are public records. Page tof 10 id ur B. x ONLY the nile of al unemancipated minors n your househld below. A minor i chia under 16 years are a aanepate by mariage, enlament the US milary or court order for emanelpation. Note: You must list the full name of each minor child on the Confidential Form available at the ‘end of this document. INITIALS FOR JOB TITLE NATURE OF UNEMARGIPATED Business “nos PROPERTY INTERESTS 1. As of December 31, 2015, did you, your spouse, or members of your immediate family: A. Have an ownership interest in North Carolin rel estate (Including your residence) with a market value of $10,000 or more? Oves lg Owner of Real Estate | % Ownership Interest 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? ves \grfo Name of Lessor Name of Lessee | 1f Real Estate, Location | If Personal Property, Renter) oy City & County Describe 2. At any time during 2014 or 2015, did you, your spouse, or members of your inmediate family sell to or buy from the Site 7 orth Carolina personal property wih a marke value of $10,000 or more? Oves Xho Name of Purchaser —-—1 Setter fi The SEE and any attachments, excluding the Confidential Form, ars public records. Page20r10 NNN FINANCIAL INTERESTS 3. As of December 31, 2015, did you, your spouse, or members of your immediate family own any of the following financial interests valued at $10,000 or more? A. Stock in a publicly owned company? Oives No — Do mot list Bwhership 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 (ii) 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 plan. Owner of Interest Full Name of Company (Do not use a ticker symbol) 8. Stock Options In a company or business? Oves gto Owner of Stack Option Full Name of Company (Do not use a ticker symbol) C. Interests in a non-publicly owned company or business entity (including interests in sole proprietorships, partnerships, limited partnerships, joint ventures, limited liability companies, limited liability partnerships, and Closely held corporations)? Ces 3A If "No," proceed to question 4. Owner of Interest Name of Company or Business Entity C (1). For each non-publicly owned company or business entity (the “primary company”) identified in question 3.C above, please list the names of any other companies or business entities in which the primary company owns securities or equity interests valued at over $10,000, if known. Non-Publicly Owned Company or Business Entity Other Companies in which the Primary Company. (the Primary Company) Owns Security or Equity Interests [0] None or Not Known The SET and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 © C(2). If you know that any company or business entity listed in 3.C or 3.C(1) above has any material business. dealings or business contracts with the State of North Carolina, or is regulated by the State, provide a ‘brief descnpiion of thet business activity ‘Name of Company or Business Entity Description of Business Activity with the State [J None or Not Known | 4. As of December 31, 2015, were you, your spouse, or members of your immediate family the beneficiaries. of a vested 370,000 or more hat was created, established, or contralied by you? Do not fist assets held in blind trusts. See 2016 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” | Oves ad Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. As of December 31, 2015, 6d you, your spouse, or members of your immeate family have lables of $10,000 or ore SX hE MoTGaR4 on your pany personal residence? Examples InaUde credit cad debts, auto loans, Student Jeans, pessonal loans and inira-family debt. ATE ONo ‘Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Vember) Indniduar, ete) ; y A Bonk Vai A Co, Ts I 6. List each sourcé of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your immediate family during 2015. Include salary, wages, state/iocal government retirement, professional fees, Honora Sater: divends, outa Income, business income, and othe types of Income required to be reported on Your State and federal ax returns. Do at include income received from the following sources: » Capital gains » Federal government retirement > Miliary retirement » Social security income/SSDI Recipient of Income Name of Source Type of Type of Income Business/Industry 11d no reportable income over $5,000 in 2015. The SE and any attachments, excluding the Confidential Form, are public records. Page 40f 10 | pmoresstonaL ap civic retatronstPs 7(a). During 2015, were you, your spouse or 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 Te re ova su pt ae t,o Sesion pie] ves Ye rove” proceso cstn. To So rd or sn, o nies ene A HS oe Se ea meat person | Mis/ie poston | __ Name of Nomprafe__| Nature of Business or compan rene on | Pompere of rammisaan Sn rr soreratars a agar ted shore do buiess wih oe Sate of ort Carol or rcv or nes bow 5 wih ch So cs cols oily Nam of Nonproft Corporation o Orgaaation Desiribe Stat Business or Stat Faming Titon or ot known SE — ®. During 2015, were you, your spouse, or members of your immediate family a director, officer, or governing board io avon ros who ar Fe, ers cvs hE voor 5a 1 SoS oy RL ves v4 I] Legiatoruical Oct «You ar not required o complete th question f you are fing because a ae 1 0 It csanizaton of whieh you rs ly member (1k srg in nds rl). Nam or person ———r— preem—— of Soy, Pesan a Eo mies The SEL and any attachments excluding the Confidential Form, are public records sages arto Same of eh company a buns WY WIR yu ee assocated where yo oa member of your IDSs + | family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2015. {7% Bune esos ~ or sroces o ues 10 SO) Tyos kro Fa ay Gmpary or Diss ary sed (2) bv ad ay mater uns desis o business contracts with the State of North Carolina or was regulated by the State as of December 31, 2015, provide a Se os sy Nama of Company or Business EVERY Sesaipton a Besmees Actwiy wit he Ste Te pple ete et on #58) _ LING ators Not known pry ——— I ve’, hack ech category fel epresenoton in Why a hela rm wth which you a afte hs carne legal fees of more than $10,000 during 2015. [Ery— amty Fer— Dem [0] Decedent's Estates [J Environmental [Insurance 0 Labor Citoct Goverment Rent property Oseantes Cres itertitpaton (noting Cluomesvepuaton CJ Othr category ot td. gn CL Dunne 2015, ware you 3 lees profesional oer on an sare) o dd you prods caning sence: ere Fo Be ee po areca wa ho Sor $1030 So Oves {No Type of usiness Nature of Seaces Rendered The SEL and any attachments, excluding the Confidential Form, are publi records. pogo sor 10 12. Are you or your employer, your spouse or members of your immediate family, or their employer currently: “| + Licensed by the State board or employing entity with which you are or will be associated or + Regulated by the State board or employing entity with which you are or will be associated or + Have a business relationship with the State board or employing entity with which you are or will be associated? Oves 0] Legistator/3udical Officer - You are not required to complete this question if you are fling because . you are a legislator or a judicial offcer ("judicial officer” is defined in the SEI Helpful Tips) or You are fling as an appointee to those offices. Name of Person Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) 13. Are you, your spouse or a member of your immediate family currently registered as a lobbyist or lobbyist principal, or were you registered as such within the 12 months receding vou filing of this form? Oves Jefe Nam of Lobbyist Lobbyist's Principal Date of Registration Registration Expiration OTHER DISCLOSURES — scene onesie 14. During any calendar quarter In 2015 (but only the time period after you were appointed, employed or fled or were nominated as a candidate), did you + receive any “gif(s)" exceeding $200 per quarter from person or group of persons acting together, and « when both you and those person(s) were outside North Carolina at the time you accepted the gifs), and + the git(s) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying? ves Ix a flo Do not report gifts given by members of your extended family. » D0 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.” Pe thom Reseed | Nome saree of Borer® [eto sce | esimygppnes | The SET and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15." During 2015 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) « those person(s) were outside North Carolina and ne If “Yes, list all contributions you (NOT immediate family members) made during 2015 with a cumulative whatsoever.” — BR 17." Are you an appointee or prospective appointee to: a. the head of a principal state department (e.g. cabinet secretary) appointed by the Governor; or b. 2 North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court Judge; or <a member of any of the following boards: + ABC Commission + Coastal Resources Commission + State Board of Education Oves xno © State Board of Elections + Division of Employment Security If "Nos proceed to © Environmental Management Commission Question 18. + Industrial Commission © Human Resources Commission + Rules Review Commission « Board of Transportation © UNC Board of Governors + Utities Commission + Widife Resources Commission 4 If so, were you appointed or are you being considered for appointment to that | [Yes (No public position by a Counci of State memer? Council of State members are sted | 1y wna" proceed to in question 16. aa © 150, you must Indicate whether during 2015 you (not immediate family members) engaged in any of the following actives with respect to or on behalf of he candidate or campaign committee of the Council of State member who appainted you to your public position: Oves CiNo 1. Collected contributions from multiple contributors, took possession of such multiple contributions, and transferred or delivered those collected Contributions to the candidate or committee? Contributions are defied in Question 16. i. Hosted a fundraiser at your residence or place of business? Oves ONe i. Volunteered for campaign-related activites, which include, but are not Imited to, phone banks, event assistance, malings, canvassing, surveying, or any | (Yes [INo Gener activity that advances the campaign of a candidate? 16. Have you ever been convicted of a felony for which you have not received either: () a pardon of innocence; or (i) an order of expyngement regarding that conviction? | Oves PY 19. Are you aware of any other information that you believe may assit the State Ethics Commission In advising You Concerning your compliance with the State Government EEhcs AC? Oves Po if yes, please provide such information below. The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 AFFIRMATION Taff that the information provided in this Statement of Economic Interest and any attachments hereto are rue, complete, and accurate {0 the best of my knowledge and belief. Lalso certify that I have not transferred, and will not transfer, any asset, terest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. 1 understand that my Statement of Economie Interest and any attachments or supplements thereto (with the exception of the | Confidential Form regarding Unemancipated Children) are public record. Tacknowledge that | have read and understand N.C.G.S. 138A-26 regarding concealing or ailing to disclose material information and N.C.G.S. 138A-27 regarding providing flse information: § 138-26. Concealing or filing to disclose material information. A filing person who knowingly conceals or knowingly iil to disclose information that is required to be disclosed on a statement of economic interes: under this Article shall be guilty ofa Class 1 misdemeanor and shal 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 a required under this Aticle knowing that the information is fase i guilty of a Class H felony and shall be subject to disciplinary action under ra A A Te Y/VETe Printed Name : a Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. EE The SEX and any attachments, excluding the Confidential Form, are public records. Page 10 0f 10