Bettie Grace Cofield

pe For Stat Use Only. Gry STATE ETHICS COMMISSION —— OR) ae Reco en 2 {/i] 2021 STATEMENT OF ECONOMIC INTEREST RECEIVE | & NO CHANGE FORM This entire form must be completed to fulfill APR1320 your SEI filing obligation. NCETHICS COMMIS | Fler's Name (First, Widdie, Last) 5 3 [Prefix | First Name EL Name Last Name [sum | [Bete [S Cofield Reason for Fling (Complete al that apply.) State Government Job (Speci sgency ond postion.) Board) Commission (it the complete names of al State | Boards an hich fou are s4i1a or are beng condicerec,) Talia Camm unrty Colleae | Board of Tiuskees Judicl Offer (Speely affee) Legislator (Specify House or Senate) } RR 1 have carefully reviewed my most recently lec Statement of Economic Interest Long Form and my réssanses continue te true, correc, and complete to the best of my knowlecge and betel. 1 have not transerred, anc will not transfer, any asset, interest, or property for the pursose of concealing from disclos.re while retaining on equiable interest Tundersiand that my No Charge Form is » pusic recerd. neve rend an understand th following sisues | N.C.G.5. § 1384-26. Concesting or fang to clsciose material formation A ling persan who knowingly conceals o knowingly fal to disclose information that i required o be csclosed on 2 Statement of economic interest... shell oe Gulty of 3 Class 1 miscemesnor and. Subject 0 dsc shnary action ander G.5. 138A.45, N.C.G.S. § 1388-27. Penalty for false information. A fing persan who provides fase information on a statement of economic Inarest .. knowing that tne informetion i false i Guity of Class felony and shall be Subject to isc inary Scion under G.5. 1384-25 Taffirm under penalty of perjury that the foregoing Is true and correct. A ig J) | i: tel 4/5/2827 | Signature ~~ Gate iA I | 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 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 Miss Bettie Grace Cofield Current Employer Job Title Cofield Mortuary Manager/Funeral Directress Nature or Type of Business Funerals 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.) Halifax Community College Trustees 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 Bettie Grace Cofield (Self) Cofield Mortuary 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.) 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 Bettie Grace Cofield (Self) Cofield Mortuary Funeral Service Salary 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 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 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 Bettie Grace Cofield Self Cofield Mortuary Officer - President 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 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 Funeral Service Funeral Service 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 03/25/2020 Signature Date Bettie Grace Cofield Printed Name Submit signed, original documents only. Do not fax or e-mail this form.

FEN FoR star Use Gar) STATE ETHICS COMMISSION ove necenea: MAR 28 2019 Hg) 2019 STATEMENT OF ECONOMIC INTEREST STATEETHICS reson = NO-CHANGE FORM check or competion 2 This entire form must be completed to fulfil your | samed 47 one 2\A\ ethics filing obligation. A Flers Nome (Fst, Middle, Last) bes | neces cotieta Reason fo Filing (Complete al that apply. State Government Job (Specity agency and position.) Bo0rd/Commission (Lst the complete names of ol State boards on which you are serving or are being considered. Judicial Officer (spect office. Legislator (specify House or Senate.) 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 belie, Ihave not transferred, and wil not transfer, any asset, interes, or property for the purpose of concealing t from disclosure while retaining an equitable interest. 1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding Unemancipated Chidren public records. Ihave read and understand the following statutes: N.C.G.5. § 1634-191. Concealing or falling to disclose material information. A fing person who knowingly conceals or knowingly fall to disclose Information tht is required to be disclosed on 2 Statement of economic Interest. shall be Guilty of a Class 1 misdemeanor and . subject to disciplinary action Under G5. 1638-415, N.C.G.S. § 163-192. Penalty for false information. A fling person who provides aise information an a statement of economic interest... knowing tht the information is false i gui of Class felony and shall be subject to disciplinary action under G.5. 1634-415. Taffirm that T 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 to the best of my knowledge and belief. Taffirm under penalty of perjury that the foregoing is true and correct. J LL 32672019 Signature Bate Beri bine (orien Printed Name Submit signed, original documents only. Do not fax or e-mail this form. This entire document is a public record.

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4+. NORTH CAROLINA STATE ETHICS COMMISSION [eo cries consron vs vr| nx | Daren EL "J 2017 STATEMENT OF ECONOMIC INTEREST * NO CHANGE FORM lone p— THIS ENTIRE FORM MUST BE COMPLETED TO ccannes ome | 1LL You FILING OBLIGATIO! FULF R ETHICS TON | oon osu [FiER's Nav (FIRST, IDOLE, LAST) BN [pen First Name Middle Name - Lost Name Suttix | Reason FoR FILING (COMPLETE ALL THAT APPLY — _ ‘STATE GOVERNMENT J0B (Specify Agency and Position) | ROARD/COMMISSION (List the complete name of al State | ~ } Halifax Community College-Board of Trustees | JUDICIAL OFFICER (Specify Office) } LEGISLATOR (Speci House or Senate) TRFRmMATION Fathi that the information provided in this Statement of Economic fnterest and any attachments hereto are truc, complete, ond accurate to the bast of my knowedge and belie. | it from disclostr while retaining on equitable terest | 1 understand that my Statement of Economic Interest and any attachments or supplements thereto (with the exception of | the Confidential Form regarding Unemancipated Children) are public record. i 1 acknowledge tha I have read and understand f.C.G.S. 1384-26 regarding concealing of failing 9 disclose material | information and .C.G.5. 1381-37 regarding providing ase information i § 1384-26. Concealing or failing to disclose material information i A fiing person wha knowingly conceals or knowinaly fais o disclose information that 1s required to be disclosed on | 2 satement of aconomic interest under this Arie shall be guilty of @ Class 1 misdemeanor and shai be sublect to | | Grscphnary action Under 6.5. 138A £5. § 1388-27. Penalty for fale information. 1 fling person who provides false information on o statement of economic interest as required under this Article | Knowing that the information is aise = guilty of 3 Class H felony and shal be subject t disciplinary action under | GS. 13645 X hereby affirm that 1 have reviewed my most recently filed 2016 Statement of Economic Interest and that as of Decamber 31, 3016, my responses continue to be true, correct, and complete to the best of my knowledge and belief. | W1agres va fg - gg. (og id yds 2. Signature Ga | Printed Name ‘Submit SIGNED, ORIGINAL documents only. Do not fax or e-mail this form. SE | This entire document is a public record.

NORTH CAROLINA STATE ETHICS COMMISSION fri copmson or a on ene 4 2016 STATEMENT OF ECONOMIC INTEREST | NO CHANGE FORM i Z check or compe THIS ENTIRE FORM MUST BE COMPLETED TO sce I1f35 1 1 3 FULFILL YOUR SEI FILING OBLIGATION EY 3 OUR SEE Felt emeres in 00 pole” FILER'S NAME (FIRST, MIDDLE, LAST) rena | vist hams pore surnn REASON FOR FILING (SELECT ALL THAT APPLY) | CISTATE GOVERNMENT 08 (Please specify the agency for | [ BOARD/COMMISSION (Pease ist complete name of ll ch you work o ae being conser) State boards on which you are serving o are being _ considered) = . Md ay leg Boa of Tends 2 UDICIAL OFFICER (pleas specty the ofice you hold) | CJLEGISLATOR (lease spect House o Senate) AFFIRMATION Tair tha th Information arovided inthis Statement of Econamic Interest and any aachments hereto ar tre, Complete, 30 Euro 1 th Besk of my know Ga and Bore Lats certify that 1 have not transferred, and wil na ransfr, any asset, interest, or property for the purpose of concealing irom isos wate rekanng am equtase terest understand that my Statement of Economic Interest and any atachments o supplements thereto (wih the exception of the Contant l Form regarding Unemmoncpated Chiron) ov publ record Locknowice that 1 have read and understand N.C.G.5. 1384-26 regarding concesing or fling to disclose materi Informanian an N.C.G.5. 1398-23 reqarans proving fe information § 13626. Concealing or faing o disclose material formation, A fling person wha knowing conceals ar knowingly ads to disclose information tht is required tobe disclosed on 2 Statement af acon wheres under this APLC Shah be Buy af & Cle Tisdemeanes nd Shah be seat on Grcinary acon under 6.5. 1388-15. § 1388-22 Penaty fo fle information A fling person who provides flse formation an a statement of economic eres as recur under this Article Komi that the formation fale 1 Guiky of 5 lacs H flony and shall be subject dscpinery acon wader CE Seas of Decamiar 31, 2015, my responses continue 15 be us, correct, and complete to the best of my knowledse and beter El Tee: 5 Ce tL fife Fry “7 mA >, Aji \ | Printed Name Submit SIGNED, ORIGINAL documents anly. Do not fax or email this farm. “This entire document is public record.

si NORTH CAROLINA STATE ETHICS ‘COMMISSION i Pr 2015 STATEMENT OF ECONOMIC INTEREST Ei NO CHANGE FORM Fis ET, FOE, Wi5FEB 12 9 Ln EE — [Comm TRU 1 ([] STATE GOVERNMENT JOB (Please specify the agency for | fr] BOARD/COMMISSION (Please list complete name of all ‘which you work or are being considered) ‘State boards on which you are serving or are being. Sm 1 Halifax Community College i re | AGAR rn ey rou 7 en a va te ton or i rrr H.C... 326 ear rcs to dos mtr sent, Coen ro dra etal rns A fing pean ur mong re oes So mene rer 3 500.2, sey re rman Fr tH vrei et ov eid my most cont fl 2018 Sstment of Enon nares nd tot ry te te ee ero oy knot To — Demz Grace Lopes 2fufass Sm tone, orca SEPR—