Beverly A. Scarlett

| For staff Use ly GR) STATE ETHICS COMMISSION _ ) 2021 STATEMENT OF ECONOMIC INTEREST | RECEIVED APR 12 2071 This entire form must be completed to fulfill your ethics filing obligation. NCETHICS Commission [profi [Firstname Twiddiewame [iastwame sumx | ] aileb [1] | Neture or Type of Business ] State Government 0b (Specy agency and postion) | Board/Commission (Ls Ihe complete names of ll Sate | Boards on Which you are serving or ae being consdered.) Governors (ung Commission Sudica Officer (Specify office) Cegrtator (Speci House or Senate) Dobact Curd Jodge-®rgdn| A. Do other immediate family members reside in your household? On this form, "immediate family” ince your spouse (ures legaly separated). It aso includes members of your extended fariy (your and your spouse's children, randchidren, perents, grandparents, and SIGs, 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. Minors are chldren under 18. They are | amanespoted by marriage, enlistment m She US Miltary, or Coult 1de for EniancieLn. emancipated Minors The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 8. List only the initials of ll unemancipated minors in your household below. A minor is a hid under 18 years ld. List the full name of each minor child on the Confidential Form at the end. El aa mm r— Unemancipated | rr 17° © 1 Property interasts | 1. As of December 31, 2020, did you or any members of your mmedite family: or mores We One TE CT TI Su Oocked -—-- 5. lease or rent real estate or personal property to or from the State of North Carolina wth a market value of $10,000 or more? Oves mo | If Real Estate, Location | 1f personal Property, by City & County Describe. 2. At any time during 2013 o 2020, did you or any MEME of your IMMEGIaKe family Sel to or buy rom the State of North Cardiina personal property worth $16,000 or more? Ove fe [ Womeotpuchaser | wameorsener | Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20 10 Financial Interests 3. As of December 31, 2020, dd your ary members of your Immediate family own any of the following franca teres aed a $10,000 or mare? List ach company indwidualy. | sockina pubity owned company? ves ho > D0 cat It meres in 3 widely held Investment und (ncuding muta funds, quieted Investment companes, pension or cefrred compensation plan | 1. the fund is publicly traded or its assets are widely diversified; and | 2 nner you nor an immediace family amber rt able to contro he underying assets [ owoerofimeret | ruil Name of Company or ticker symbol 5. Stock options na company or business? ves he ‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol) [7G tnterests 12a nan-suslcly owned company or business entity? These include teress In so proprietors, Partnrani, Imied parinersnps, Jo ventures, Ime Iabity Companies, 1Med Iabity panersns, and Coney vos corporations. Bes [IN Iho,” proceed to question 4. Owner of interest T Name of Company or Business Entity ] Puck ial En C1). For sath company a busness ent Gentied in questan 3.C. (he “Pimary Company”), please Is the hares of ay oer CompaNIS or business ees In which th Primary Company owns setuntes o eaulty ares vetoed at ver £16,000, snow. Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the primary Company) Owhs Security or Equity Interests fae or ot known The SEI and any attachments, excluding the Confidential Form, are public records. Page 3010 GB you know thar ay erty Tted 10 3 or SCC) sbove hs amy mater buses desings o busines Comracks wih he Sat of Nort Carl, o 1 rege by he eae, ary Geo hak Duane ay Nome of Company or Business Entity Description of Business Activity with tha State 4. 45 of December 31.2020, were you o any members of you Imada arly th beneianeso vested rst wit ear 101005 of roe ha yo emer esas of Comoe Do not list assets held in blind trusts. See 2020 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” Cves wo Name and Address of Trustee Description of the Trust Vour Relationship to the Trust 5 Aw December 71 020.1 vou any members of you Immediate (hy Pave Tables of £10,600 or mare, excl In aricage on Jou SHAT Deol TERGERGL Exes use TGS rd Gebe, A oa, sit are | mes One Nama of Debtor Type of Creditor (commercial Sank, credit rion, Inivtanyste [Beoecly A Stolle vail Union ! 7 ! Beoesly A Scaclett Lied Buckt st ch source of income (not specie amount) of more than $5,000 received by ou cr any members of or Imada amity ring 250, Inch sar: wage, Heo QorrTe VEO Income, oreo ft Ronan mares, ShGEnG, rem) oe, SUSec Ira, TS PES Squre 0 be repos Set ad {€daral ox rein. lease remember to iScloss Your recipe of Saary o wages from any governmental or iva anny. 00 not nut income rece from tne follwnng sources: Cantal gars cers qverment reremene iar erement Soc securty ncome/Ssot Recipient of Income Name of Source Type of ] Type of Income liess/ndustry 31m 70 reportable come aver $5,900 1 2020 Broly N Stole | Tau, Uniti Losdlog Tevaat Rontal [Broaiy A Sted | Jade ln [Laval Teed wf A i Supls The Sex and any attachments, excluding the Confidntial Form, are public records. Page aor 10 Professional and Civic Relationships 7(a). During 2020, were you or any members of your immediate famly a director, officer, governing board member, employee, Independent contractor, or red/terec obbyis of a nonaroft corporation or organization operating In North Carolina primarily for religious, chartable, scientific, Iterary, public health and safety, or educational purposes? Dives TINo - If "No,” proceed to question 8. > Oo not st State boards or enities, > 00 not list crganizations of which you are & mere member. Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 700). Ifthe nonproft corporations o organizations sted above do business With the State of North Carolina or recenve State unde, rely describe the nature of ha Business, f Known or with due diigence could reasonably be known. ‘Name of Nonprofit Corporation or Organization Describe State Business fone or Not Known | EE 8. During 2020, were you or any members of your immediate family a director, officer, or Governing board member of | any society, Organization, of SGVOCAEY GFOUS WIZh an interest in matters over which your agency or board may nave | Junsaictions [ives [fo [)Legisietor/udiial Officer - You are not required to complete tis question you are ling because You are 8 legisator o sudiial officer or you are ing 85 an appointee to one of hose offices. |» 50 not st rgenizations of which you are only @ member and do not serve In a leadership role ‘Name of person Name of Society, Organization, Leadership Position or Advocacy Group. (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page sof 10 I I EE I EE ES EE I EE 9(b). If you know that any entity listed in 9(a) above had any matenial business dealings or business contracts with the rr — [ 10. are you a practicing attorney? Oves [INo [Judicial Officer/State Attorney. [J Decedent's Estates Environmental insurance [Labor - I EE 1] 12. Are you or your employer, or any members of your immed ate family, or their employers curently: + licensed by the State board or agency with which you are o will be associated or + regulated by the State board or agency with which you are or wil be associated or +n business relationship wih the Sate board or agency with which you are or will be ssocated? [Yes (INo fiegisatoruical Office - You ae not required to complete this question f you re fing because You are a legislator or a judicial oficer or you are ling as an appointee to one of those offices Name of Employer Type of Relationship f applicable) (Licensing, Regulatory, Business) I I 13. Hove you or a member of your Immediate family been registered as o lobby: or 190ByIt prinapal win the 12 | months preceding your ling of ths form? ove ho ‘Name of Lobbyist Lobbyist's principal Dateof | Registration Registration Expiration Other Disclosures 16. During 2020, afer you were appointed, employed, or fled or were nominated as 8 candidate, 4d you + receive any "0ift(s)” exceeding $200 per Guarter 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 gifs were given fo labaying? To answer Yes, al three conditions must apaly. Oves ho > Do rnot report gifts given by members of your extended family. > D0 not report gifs you have previously reported onthe "Expense Report for Exempted Persons.” [ew tam wassives | Wams smd aires omories Ectimated Market Value The SE and any attachments, excluding the Confidential Form, are public records. Page 70 10 15. Dung 2020, ater you were appointed, employed, ar fed or were nominates a5 3 condgat, od you + cept a “scholarship” exceeding $200 related to your public postion fom 3 person or Group of persons acting Logetner, + hen nose person(s) were outice Norn Carona? To answer ves, both coniions must ep. A “scholarship” is grant-n-aid, either direct or Indirect, to attend a conference, meeting, or similar ever, including tuition, travel, lodging, mesis, and other similar expenses. ves [No fusca Office - You ae not required to comple this question If you are udcial fcr or you ae lng os a dl aicer sppantee. > 00 not report its you have previously reported on the "Expense Report for Exempted Persons.” > Legislators are ot required to report scholars a by a nonpartisan eg ative organszaton of whch he egisator | or tne General Assembly 5 member, partapant, or afine. Date of | Name and Address of Donor(s) schoirsnip | | _ 1 16. Have you been appoinied or conaderd fo 3pPaIMENt to » covered board by the Governor or another Counc of | State member? | Councl of State members are: > Governor > 1 Governor > Sestoyof sate > Stee auctor > Ste Treasurer > Superendent of bic Instruction > storey General > Commissioner of Agriculture» Commissioner of Labor > Commasoner of nsurence | offes Ono IrYes, lis all contributions you made in 2020 with a cumulative total of more than $1,000 to the Council of | State member who appointed you. D0 not include contributions from immediate family members. > Conrbutons are defined brosdy in NCGS. 163-270.6(6) snd inciude “any aden, conveyance, Gepost, Gon rane of nds, oan, paymere, OF, IESE or bSETPLon of money or SENG of vile WASLSOReT [ome TT amom J Sortribitsd to fo contibtionts) win = cumulative ota of more then $1,000 The SEX and any attachments, excluding the Confidential Form, are public records. Pages oro 17. Are you an appontee or prospective appointee as: a. the head of a principal tate cepartment (.g., caoinet secretary) appointed by the Governor; or | 5. a North Carona Supreme Court Justice, Court of Appeals, Superior or District | Court Judge; or |e meme ct any ne fotoang sasas Oves ©fNo + ABC Commission IF"No,” proceed to question 15. + Coastal Resources Commission + State Board of Education + State Board of Elections. + Duvsion of Employment Security + Environmental Management Commission [ + Inoustial Commission + Human Resources Commission | + Rules Review Commission | + Board of Transportation + Utiities Commision + Widite Resources Commission 4. 11 0, were you appointed or ere you being considered or sppontment to that | (1¥es [No postion by 5 Counc of State member? con © If sb, you must Indicate whether during 2020 you engaged In any of the folowing acuviies wD respect o or on banal of the candidate or campaign Commit of the Counc of tate member who appointed you: i Collected contrioutons from multole contriutors, took possession of such | mute contributions, and transfered or evered those. collected | [Yes CINo Contributions o the candidate or Committee? IL osted a fundraiser at your residence or lace of business? Cves No 11. Volunteered for campagn-related acuvies, inciucing phone banks, event assistance, mailings, Canvassing, Surveying, or any einer acuity thet | Ives [No advances ine campaign of a candidate? 18. Have you ever been convicted of a felony for which you have not received either: () a pardon; or (1) an order of xpungement? Ores ho ortense ate of Conviction | County of Conviction State of Conviction 19. Are you aware of any other Information that you believe may assist the Ethics Commission n advising you Concerning your compliance wih the State Government EUNCS Act? [les [INo If yes, please provide that informetion below. The SEI and any attachments, excluding the Confidential Form, are public records. Pages or10 Tne formation sovided i hs Statement of Economic nkresk and any attachments ac rue, complete, and accurate he best of my knowlege and bet. | have ot transferred, an wil no rane, any asset, Inkres, or propery fort purpose of conceaing rom Cosine whie rearing on €qorable THeTes | understand tat my Statement of Economic Interest and any attachments excep or the Conf dental Form regarding | Unemancipated Chitra are pute recres 1 rave read and understand the folowing sates: NGS: § 1384-26. Concealing or falling o disclose material informatin. A fing person wha knowingly conceals or knowing fal o discos informacion tha s reared ia be disclosed 3 Sanemant of scone est Shall be gully Of a los 1 demesne and sued ts soma + | Seon under 0.5, 1380.45 i NCGS. § 1384.27. Penalty for fis information. | A fling person who provides false information on a Statement of &oPGMC neres . . . knowing that the Inlomanan 15 tse 1 git of a C:35 i felony an Sn Be S014 15 CCID Inry 3Cion under 6.5. 1368-45. 1 affrm under panalty of perjury thatthe foregoing is trus and correct. V/A | fo 9) EP Sabature Bate Pevedly A. SavlpH- Printed Nate ‘Submit signed, original documents only. Da not fax or e-mail this form. The SEE and any attachments, excluding the Confidential Form, are public records. Page 100110

| For staff Use ly GR) STATE ETHICS COMMISSION _ ) 2021 STATEMENT OF ECONOMIC INTEREST | RECEIVED APR 12 2071 This entire form must be completed to fulfill your ethics filing obligation. NCETHICS Commission [profi [Firstname Twiddiewame [iastwame sumx | ] aileb [1] | Neture or Type of Business ] State Government 0b (Specy agency and postion) | Board/Commission (Ls Ihe complete names of ll Sate | Boards on Which you are serving or ae being consdered.) Governors (ung Commission Sudica Officer (Specify office) Cegrtator (Speci House or Senate) Dobact Curd Jodge-®rgdn| A. Do other immediate family members reside in your household? On this form, "immediate family” ince your spouse (ures legaly separated). It aso includes members of your extended fariy (your and your spouse's children, randchidren, perents, grandparents, and SIGs, 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. Minors are chldren under 18. They are | amanespoted by marriage, enlistment m She US Miltary, or Coult 1de for EniancieLn. emancipated Minors The SEI and any attachments, excluding the Confidential Form, are public records. Page 1 of 10 8. List only the initials of ll unemancipated minors in your household below. A minor is a hid under 18 years ld. List the full name of each minor child on the Confidential Form at the end. El aa mm r— Unemancipated | rr 17° © 1 Property interasts | 1. As of December 31, 2020, did you or any members of your mmedite family: or mores We One TE CT TI Su Oocked -—-- 5. lease or rent real estate or personal property to or from the State of North Carolina wth a market value of $10,000 or more? Oves mo | If Real Estate, Location | 1f personal Property, by City & County Describe. 2. At any time during 2013 o 2020, did you or any MEME of your IMMEGIaKe family Sel to or buy rom the State of North Cardiina personal property worth $16,000 or more? Ove fe [ Womeotpuchaser | wameorsener | Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20 10 Financial Interests 3. As of December 31, 2020, dd your ary members of your Immediate family own any of the following franca teres aed a $10,000 or mare? List ach company indwidualy. | sockina pubity owned company? ves ho > D0 cat It meres in 3 widely held Investment und (ncuding muta funds, quieted Investment companes, pension or cefrred compensation plan | 1. the fund is publicly traded or its assets are widely diversified; and | 2 nner you nor an immediace family amber rt able to contro he underying assets [ owoerofimeret | ruil Name of Company or ticker symbol 5. Stock options na company or business? ves he ‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol) [7G tnterests 12a nan-suslcly owned company or business entity? These include teress In so proprietors, Partnrani, Imied parinersnps, Jo ventures, Ime Iabity Companies, 1Med Iabity panersns, and Coney vos corporations. Bes [IN Iho,” proceed to question 4. Owner of interest T Name of Company or Business Entity ] Puck ial En C1). For sath company a busness ent Gentied in questan 3.C. (he “Pimary Company”), please Is the hares of ay oer CompaNIS or business ees In which th Primary Company owns setuntes o eaulty ares vetoed at ver £16,000, snow. Non-Publicly Owned Company or Business Entity | Other Companies in which the Primary Company (the primary Company) Owhs Security or Equity Interests fae or ot known The SEI and any attachments, excluding the Confidential Form, are public records. Page 3010 GB you know thar ay erty Tted 10 3 or SCC) sbove hs amy mater buses desings o busines Comracks wih he Sat of Nort Carl, o 1 rege by he eae, ary Geo hak Duane ay Nome of Company or Business Entity Description of Business Activity with tha State 4. 45 of December 31.2020, were you o any members of you Imada arly th beneianeso vested rst wit ear 101005 of roe ha yo emer esas of Comoe Do not list assets held in blind trusts. See 2020 SEI Helpful Tips for the definition of "Vested Trust” and “Blind Trust.” Cves wo Name and Address of Trustee Description of the Trust Vour Relationship to the Trust 5 Aw December 71 020.1 vou any members of you Immediate (hy Pave Tables of £10,600 or mare, excl In aricage on Jou SHAT Deol TERGERGL Exes use TGS rd Gebe, A oa, sit are | mes One Nama of Debtor Type of Creditor (commercial Sank, credit rion, Inivtanyste [Beoecly A Stolle vail Union ! 7 ! Beoesly A Scaclett Lied Buckt st ch source of income (not specie amount) of more than $5,000 received by ou cr any members of or Imada amity ring 250, Inch sar: wage, Heo QorrTe VEO Income, oreo ft Ronan mares, ShGEnG, rem) oe, SUSec Ira, TS PES Squre 0 be repos Set ad {€daral ox rein. lease remember to iScloss Your recipe of Saary o wages from any governmental or iva anny. 00 not nut income rece from tne follwnng sources: Cantal gars cers qverment reremene iar erement Soc securty ncome/Ssot Recipient of Income Name of Source Type of ] Type of Income liess/ndustry 31m 70 reportable come aver $5,900 1 2020 Broly N Stole | Tau, Uniti Losdlog Tevaat Rontal [Broaiy A Sted | Jade ln [Laval Teed wf A i Supls The Sex and any attachments, excluding the Confidntial Form, are public records. Page aor 10 Professional and Civic Relationships 7(a). During 2020, were you or any members of your immediate famly a director, officer, governing board member, employee, Independent contractor, or red/terec obbyis of a nonaroft corporation or organization operating In North Carolina primarily for religious, chartable, scientific, Iterary, public health and safety, or educational purposes? Dives TINo - If "No,” proceed to question 8. > Oo not st State boards or enities, > 00 not list crganizations of which you are & mere member. Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 700). Ifthe nonproft corporations o organizations sted above do business With the State of North Carolina or recenve State unde, rely describe the nature of ha Business, f Known or with due diigence could reasonably be known. ‘Name of Nonprofit Corporation or Organization Describe State Business fone or Not Known | EE 8. During 2020, were you or any members of your immediate family a director, officer, or Governing board member of | any society, Organization, of SGVOCAEY GFOUS WIZh an interest in matters over which your agency or board may nave | Junsaictions [ives [fo [)Legisietor/udiial Officer - You are not required to complete tis question you are ling because You are 8 legisator o sudiial officer or you are ing 85 an appointee to one of hose offices. |» 50 not st rgenizations of which you are only @ member and do not serve In a leadership role ‘Name of person Name of Society, Organization, Leadership Position or Advocacy Group. (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Page sof 10 I I EE I EE ES EE I EE 9(b). If you know that any entity listed in 9(a) above had any matenial business dealings or business contracts with the rr — [ 10. are you a practicing attorney? Oves [INo [Judicial Officer/State Attorney. [J Decedent's Estates Environmental insurance [Labor - I EE 1] 12. Are you or your employer, or any members of your immed ate family, or their employers curently: + licensed by the State board or agency with which you are o will be associated or + regulated by the State board or agency with which you are or wil be associated or +n business relationship wih the Sate board or agency with which you are or will be ssocated? [Yes (INo fiegisatoruical Office - You ae not required to complete this question f you re fing because You are a legislator or a judicial oficer or you are ling as an appointee to one of those offices Name of Employer Type of Relationship f applicable) (Licensing, Regulatory, Business) I I 13. Hove you or a member of your Immediate family been registered as o lobby: or 190ByIt prinapal win the 12 | months preceding your ling of ths form? ove ho ‘Name of Lobbyist Lobbyist's principal Dateof | Registration Registration Expiration Other Disclosures 16. During 2020, afer you were appointed, employed, or fled or were nominated as 8 candidate, 4d you + receive any "0ift(s)” exceeding $200 per Guarter 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 gifs were given fo labaying? To answer Yes, al three conditions must apaly. Oves ho > Do rnot report gifts given by members of your extended family. > D0 not report gifs you have previously reported onthe "Expense Report for Exempted Persons.” [ew tam wassives | Wams smd aires omories Ectimated Market Value The SE and any attachments, excluding the Confidential Form, are public records. Page 70 10 15. Dung 2020, ater you were appointed, employed, ar fed or were nominates a5 3 condgat, od you + cept a “scholarship” exceeding $200 related to your public postion fom 3 person or Group of persons acting Logetner, + hen nose person(s) were outice Norn Carona? To answer ves, both coniions must ep. A “scholarship” is grant-n-aid, either direct or Indirect, to attend a conference, meeting, or similar ever, including tuition, travel, lodging, mesis, and other similar expenses. ves [No fusca Office - You ae not required to comple this question If you are udcial fcr or you ae lng os a dl aicer sppantee. > 00 not report its you have previously reported on the "Expense Report for Exempted Persons.” > Legislators are ot required to report scholars a by a nonpartisan eg ative organszaton of whch he egisator | or tne General Assembly 5 member, partapant, or afine. Date of | Name and Address of Donor(s) schoirsnip | | _ 1 16. Have you been appoinied or conaderd fo 3pPaIMENt to » covered board by the Governor or another Counc of | State member? | Councl of State members are: > Governor > 1 Governor > Sestoyof sate > Stee auctor > Ste Treasurer > Superendent of bic Instruction > storey General > Commissioner of Agriculture» Commissioner of Labor > Commasoner of nsurence | offes Ono IrYes, lis all contributions you made in 2020 with a cumulative total of more than $1,000 to the Council of | State member who appointed you. D0 not include contributions from immediate family members. > Conrbutons are defined brosdy in NCGS. 163-270.6(6) snd inciude “any aden, conveyance, Gepost, Gon rane of nds, oan, paymere, OF, IESE or bSETPLon of money or SENG of vile WASLSOReT [ome TT amom J Sortribitsd to fo contibtionts) win = cumulative ota of more then $1,000 The SEX and any attachments, excluding the Confidential Form, are public records. Pages oro 17. Are you an appontee or prospective appointee as: a. the head of a principal tate cepartment (.g., caoinet secretary) appointed by the Governor; or | 5. a North Carona Supreme Court Justice, Court of Appeals, Superior or District | Court Judge; or |e meme ct any ne fotoang sasas Oves ©fNo + ABC Commission IF"No,” proceed to question 15. + Coastal Resources Commission + State Board of Education + State Board of Elections. + Duvsion of Employment Security + Environmental Management Commission [ + Inoustial Commission + Human Resources Commission | + Rules Review Commission | + Board of Transportation + Utiities Commision + Widite Resources Commission 4. 11 0, were you appointed or ere you being considered or sppontment to that | (1¥es [No postion by 5 Counc of State member? con © If sb, you must Indicate whether during 2020 you engaged In any of the folowing acuviies wD respect o or on banal of the candidate or campaign Commit of the Counc of tate member who appointed you: i Collected contrioutons from multole contriutors, took possession of such | mute contributions, and transfered or evered those. collected | [Yes CINo Contributions o the candidate or Committee? IL osted a fundraiser at your residence or lace of business? Cves No 11. Volunteered for campagn-related acuvies, inciucing phone banks, event assistance, mailings, Canvassing, Surveying, or any einer acuity thet | Ives [No advances ine campaign of a candidate? 18. Have you ever been convicted of a felony for which you have not received either: () a pardon; or (1) an order of xpungement? Ores ho ortense ate of Conviction | County of Conviction State of Conviction 19. Are you aware of any other Information that you believe may assist the Ethics Commission n advising you Concerning your compliance wih the State Government EUNCS Act? [les [INo If yes, please provide that informetion below. The SEI and any attachments, excluding the Confidential Form, are public records. Pages or10 Tne formation sovided i hs Statement of Economic nkresk and any attachments ac rue, complete, and accurate he best of my knowlege and bet. | have ot transferred, an wil no rane, any asset, Inkres, or propery fort purpose of conceaing rom Cosine whie rearing on €qorable THeTes | understand tat my Statement of Economic Interest and any attachments excep or the Conf dental Form regarding | Unemancipated Chitra are pute recres 1 rave read and understand the folowing sates: NGS: § 1384-26. Concealing or falling o disclose material informatin. A fing person wha knowingly conceals or knowing fal o discos informacion tha s reared ia be disclosed 3 Sanemant of scone est Shall be gully Of a los 1 demesne and sued ts soma + | Seon under 0.5, 1380.45 i NCGS. § 1384.27. Penalty for fis information. | A fling person who provides false information on a Statement of &oPGMC neres . . . knowing that the Inlomanan 15 tse 1 git of a C:35 i felony an Sn Be S014 15 CCID Inry 3Cion under 6.5. 1368-45. 1 affrm under panalty of perjury thatthe foregoing is trus and correct. V/A | fo 9) EP Sabature Bate Pevedly A. SavlpH- Printed Nate ‘Submit signed, original documents only. Da not fax or e-mail this form. The SEE and any attachments, excluding the Confidential Form, are public records. Page 100110

rosut o GE STATE ETHICS COMMISSION i RAs El 3 RECEIVED RAZ) 2020 statemENT OF ECONOMIC INTEREST CH) APR 13 2020 NO ETHICS COMISSION This entire form must be completed to fulfill mene CE G5 comp your ethics filing obligation. — Scanned ____Date a Su ands Coy suo. rceved ie pivpye— iors om (Fr, de, ow) Cho [Dior lowt dge | Rasen Tor Fling Complete al ht 360) eh ou ar ser o ars bang donsdere.) Digit Lost Jodge Conearorts Cine Comission Soda Oar pect ofee) Cogito (Spey Rouse or arate) 'n. Do other Immediate family members reside in your household? Ove who on ths form, "immediate family” include your spouse {unless ely separate). ¢ fo includes membre of your irr arasicnir an paar, parents, and SUT, and he Spouses eno host gers) who reeds in your household. othe ll nome of all adults an smancipated minors n your hoshold Hier are chien under 19. They are on tmer mt Us ily o cout order fo emancpaton emancipated Minors Th SE and any aachments, excluding the Confidential Form, ar public records. Pave dors Lith ul ne ofeach minor child on th Condens Form tthe end. prey FRET pr ‘Unemanciated property inerests hve an ore eet th arsine as chin your E80) wi 3 mara lof $1050 we ov See odioched [owner of Ren Estat | on owners incre | tocationby Gity__| Location by Coury Oves v6 Nema ariammes | Rata, Location | If personal mopar, ons or aon Secures ol a Soom meer Olives lo rr IY 7 MN TY 1.7 3. oof December 3, 2019, did you or any members of your immediate family own any of the following inancil interests Uaided st $10,000 or more? List sach company individually. A. Stock in a publicly owned company? ves wre > Do not st nerests n 3 widely eld investment fund (including mutual funds, regulated Investment companies, or pansion o deferred compensation plans) 1. the fund publicly traded or ts assets are widely diversified; and 3. nether you nr an Immediate family member are able control the underlying assets. | owneroftmeest | ull Name of Company or ticker symbol 5. Stock options n 8 company or business? Ove wf Full Name of Company (Do not use a ticker symbol) 'C. nterests In a non-public owned company or business entity? These include Interests In sole propriearsips, partnerships, mid porthrships, Joi ventures, hed abit companies, limited ablty partnerships, and Cosel nei corporations. [Yes [510 - IF "No," proceed to question 4. | ownerormmmes | "Name of Company or Business Entity C1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the Rares of any ether Companies o business ene in which the Primary Company owns securities or eauty Interests vlued a over $10,000, 1 known. Non-publicy Owned Company or Business Entity | Other Companies in which the primary Company. (the primary Company) “Owns Security or Equity Interests The SEX and any attachments, excluding the Confidential Form, are public records. Page 3010 Ey a Ep ry a a eo eas Oves fe @%es Ono pre Emp Feeee— costed Fedwol (redid lion | Credid Ua Dart Yd Dee a EE Sa em Tarn my ly mp male rr tne ASI! ov oe pr m— = Te rnsy TA \ale of NC | Euglognent | Professional and Civic Relationships ET ep — Ee aman ova ere ha, ets fay. recs, govern bard rember, Ro Cth ena To apes Soe am ae copra ¢ rg cparaing Dives Be: he? poets quetons. FET re i ns ve Sw mens a ee ym: corpo Spain | pups Samization ETT ep —— i YS rr Ss rr rE —————— a aus omy 3 Aisa, hk, or pang bd parr of it] Er 0 pd i te on SoA EPS Bt Pas mae I A os sin Een gha P50 giorno yo eo ee 0 ae etc er ET at rE The 5 and amy atachments, exciting th Confidential Pom, ar pub vcords Pose sar 5(a). List the name of each business with which you were associated where you or a member of your immediate family Was an ampoye, directo, of ca, Parner, propricor or member or manager 54 of December 31, 2015, No Business Associations S(5). Ifyou know that any enty 156d 11 5(a) above had any material uUsingss dealings or BUSIGss contracts with the State of North Carolina or was reguIatad by the State 6 of December 31, 2013, biel describe that actwiy. "Name of Company or Business Entity ‘Description of Business Activity with the State (ot sppicable (No entities sted on #99) 10. Are you a pragyeing attorney? Oves fo [ud Offcer/state Atorney. 18 "Yes, check each category of legal representation n which you or the law fim with which you ae afiate hs eamed legal foes of more then $16,000 during 2015. () Administrative () Admiralty [Corporate Criminal [J Decedent's Estates (0 Environmental [OInsurance 0 Labor [J Local Government [Real Property [securities OTax Tot tigation (including 0) Utites Regulation Clothe catagory not sted negligence) 11. During 2019, were you a licensed professional (other than an attomey) or id you provide consulting services Indnidually or 334 amb of a professional assoc ation for which you charged or were paid over $10,000% Ores an oar or series Redon Tha SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. re you or your ampere, ar any members of you Imada em, or ar amayers camer + cons b the tate board or agency ith which yo ar o wil be associated or + regulated by th Sate beard a agency with which you ar o wil bs asada or rn it Oa rr ty [Yes (INo (tagsiatoriuicial Offer - You ar ot required to complete this uestion yu are ling because Yo are a eit o 3 kel ocr or you rs Hi a 4 oppomcn ts ne of hs Name of Employer Type of Relationship Gt appicabiey Cicansing, Regulatory, Business) 13. Have you or a member of your mmedats family boa registered 25 3 bey o boy pena win he 12 ores receding vor fh of os forms Ove mf Name of Labbyint Lobbyists Princpal Dare of Regiatration Region | "Seption Other Disclosures — } 15. During 2019, after you were applied, ampeyed,o led o were nominated a2 conan, 4d you = receive any "g()"exceaing 200 par curr fom person or group of persons actin toga, hen bth you and thos person(s) were outside North Carona, + under circumstances tot wold lead essanabe person to conde the gifs were given for abbying? To answer Yes, al tree condition must apy. Ove a6 > not report is given by members of your extended foi 00 ot report its you hav previously reported on the pense Report for Exempted Persons. Ee — Name and Address of Donor(s) | Describe Item Received [Fr] The SEE and any attachments, excluding the Confidential Form, are public records. Page7or10 15, During 2015, after you were appointed, employed, or fled or were nominated a5 candidate, dd you + accept “scholarship” exceeding $200 relate to your public positon from a person ar group of persons acting together, + when those person(s) were outside North Carolina? To answer Yes, both conditions must app. A scholarship” is a grant-in-id, ither direct or Indirect, to attend a conference, meting, or similar event, including tuiton, raval, odging, mesle, and other similar expenses. Yes CINe (fl Offer - You ae not requred to comple ths question you are a judicll office or you are fing 0 a Judicial aficer sppoinie. > D0 not report its you have previously reported on the “Expense Report for Exempted Persons.” > Legisators are not required to report scholarships paid by a nonpartisan legislative organization of which the legislator or the General Assembly 1 3 member, partcpant, o afiate Date of | Name and Address of Bonor(s) Estimated Market Scholarship Value 16. Have you been appointed or considered for appoint to covered board by the Governor or another Cound of State member? Council of State members are: > Governor > Le Governor > Secretary of Sate > State auditor > State Treasurer > Superintendent of Public Instruction > Attorney General > Commissioner of Agriculture Commissioner of Labor > Commissioner of Insurance Oves 1 “Yes, ist 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 NCGS. 163-278.6(6) and include any advance, conveyance, depos, distribution, transfer of funds, Ian, payment, 0, pledge or subscriten of money or anything of value. whatsoever. Date Amount Contributed to CINo contributions) with cumulative total of more than $1,000 The SET and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 17. you i appantes or prospective apples an a. te head of a principl sate depariment e.g. cab: secretory) sppoted oy 5. a North Carolina Supreme Couet utc, Court of Appeals, Superior or District Coun ude or a member of any of the follwing boars: Ove rbe + hec commissan IF No, proceed to question 16. + Constl Resources Commission + Stte Board of Education + State Board of Electors + Otvsion of Empoymen Security + Environmental Management Commission + Industral Commission + Human Resources Commission + Rules Review Commissan © Bowraof Transportation + Utites Commision + _ Wife Resources Commission a. 1 50, were you appointed or are you beng considered for apparent to hat | ves [Ie postion by Counc 1 Soe mempers a ait ef so, you must ndcate whether dung 2059 you engaged n any of the following actives wih respec t or on bahalf of the Candis or cummin Commies of the Counc of Sate meres who spponcia you i Collected contributions rom multe conributors, too possession of such mulile contributions, and transfered or ddered ieee. ctessed Contrutions a the corte or comes I. Hosted funcrarsr at your residence o place of business” Dves Ovo Wh. Voluteered fo campagn-relted aces, incuding phone barks, eves assistance, Mallngs, Canvassing, Seng o any Ser acini sek |) ¥es CIN advances ina ompoign of 8 andre? 10. Have you ever been convicied of a eony for whch you have ne received she: () pardons o (1) an are of Ove wf [mms [outeof Conviction | county of Conviction | state of Conviction 19,76 you re of any oer information hat you elev may 355 he ies Comission In Sawa ou CORCemIng your compan wih he Se Covermmnen Eee ets Bes [IN if yes, please provide that information below. My mala ues o malay of wy household. She transition on 49-2010. tec estate renuns Geen: Tan inthe prouss of hons- Dering hee real estat as ker greading: The SEX and any attachments, excluding the Confidential Form, are public records. Page sor 10 he information provided n Uv Statement of Economie terest and ay attachment ar rv, complete, and acute oe sao oy eno an se ave no trons, nd wil no arte, ay ase, ners, o propery forthe purpose of canceling I rom nase ve aay a enone mere understand tat my Statement of Economic teres and any attachment xcept for the Contr Frm regarding i St have read and understand the flowing sats: A fing gas who nowy concels or kningly fa odie frat tha recur ob dosed a Se rt ft a Sianome MCG. § 1304.27. Penaty for tise formation. Ain parson who roids ls formation a satmen of economic tet... rowing that the oat 8 5 yo 3 Cie os ee RS Xai under penalty of pariury that the foregoing is true and correc, 4. 5- 8019 nl pe Bovey A Suet Prec NT DE ————————— The SEE and ay atachmmats, sxcuding the Comma For, ar pabli record Page 10010

rosut o GE STATE ETHICS COMMISSION i RAs El 3 RECEIVED RAZ) 2020 statemENT OF ECONOMIC INTEREST CH) APR 13 2020 NO ETHICS COMISSION This entire form must be completed to fulfill mene CE G5 comp your ethics filing obligation. — Scanned ____Date a Su ands Coy suo. rceved ie pivpye— iors om (Fr, de, ow) Cho [Dior lowt dge | Rasen Tor Fling Complete al ht 360) eh ou ar ser o ars bang donsdere.) Digit Lost Jodge Conearorts Cine Comission Soda Oar pect ofee) Cogito (Spey Rouse or arate) 'n. Do other Immediate family members reside in your household? Ove who on ths form, "immediate family” include your spouse {unless ely separate). ¢ fo includes membre of your irr arasicnir an paar, parents, and SUT, and he Spouses eno host gers) who reeds in your household. othe ll nome of all adults an smancipated minors n your hoshold Hier are chien under 19. They are on tmer mt Us ily o cout order fo emancpaton emancipated Minors Th SE and any aachments, excluding the Confidential Form, ar public records. Pave dors Lith ul ne ofeach minor child on th Condens Form tthe end. prey FRET pr ‘Unemanciated property inerests hve an ore eet th arsine as chin your E80) wi 3 mara lof $1050 we ov See odioched [owner of Ren Estat | on owners incre | tocationby Gity__| Location by Coury Oves v6 Nema ariammes | Rata, Location | If personal mopar, ons or aon Secures ol a Soom meer Olives lo rr IY 7 MN TY 1.7 3. oof December 3, 2019, did you or any members of your immediate family own any of the following inancil interests Uaided st $10,000 or more? List sach company individually. A. Stock in a publicly owned company? ves wre > Do not st nerests n 3 widely eld investment fund (including mutual funds, regulated Investment companies, or pansion o deferred compensation plans) 1. the fund publicly traded or ts assets are widely diversified; and 3. nether you nr an Immediate family member are able control the underlying assets. | owneroftmeest | ull Name of Company or ticker symbol 5. Stock options n 8 company or business? Ove wf Full Name of Company (Do not use a ticker symbol) 'C. nterests In a non-public owned company or business entity? These include Interests In sole propriearsips, partnerships, mid porthrships, Joi ventures, hed abit companies, limited ablty partnerships, and Cosel nei corporations. [Yes [510 - IF "No," proceed to question 4. | ownerormmmes | "Name of Company or Business Entity C1). For each company or business entity identified in question 3.C. (the “Primary Company”), please list the Rares of any ether Companies o business ene in which the Primary Company owns securities or eauty Interests vlued a over $10,000, 1 known. Non-publicy Owned Company or Business Entity | Other Companies in which the primary Company. (the primary Company) “Owns Security or Equity Interests The SEX and any attachments, excluding the Confidential Form, are public records. Page 3010 Ey a Ep ry a a eo eas Oves fe @%es Ono pre Emp Feeee— costed Fedwol (redid lion | Credid Ua Dart Yd Dee a EE Sa em Tarn my ly mp male rr tne ASI! ov oe pr m— = Te rnsy TA \ale of NC | Euglognent | Professional and Civic Relationships ET ep — Ee aman ova ere ha, ets fay. recs, govern bard rember, Ro Cth ena To apes Soe am ae copra ¢ rg cparaing Dives Be: he? poets quetons. FET re i ns ve Sw mens a ee ym: corpo Spain | pups Samization ETT ep —— i YS rr Ss rr rE —————— a aus omy 3 Aisa, hk, or pang bd parr of it] Er 0 pd i te on SoA EPS Bt Pas mae I A os sin Een gha P50 giorno yo eo ee 0 ae etc er ET at rE The 5 and amy atachments, exciting th Confidential Pom, ar pub vcords Pose sar 5(a). List the name of each business with which you were associated where you or a member of your immediate family Was an ampoye, directo, of ca, Parner, propricor or member or manager 54 of December 31, 2015, No Business Associations S(5). Ifyou know that any enty 156d 11 5(a) above had any material uUsingss dealings or BUSIGss contracts with the State of North Carolina or was reguIatad by the State 6 of December 31, 2013, biel describe that actwiy. "Name of Company or Business Entity ‘Description of Business Activity with the State (ot sppicable (No entities sted on #99) 10. Are you a pragyeing attorney? Oves fo [ud Offcer/state Atorney. 18 "Yes, check each category of legal representation n which you or the law fim with which you ae afiate hs eamed legal foes of more then $16,000 during 2015. () Administrative () Admiralty [Corporate Criminal [J Decedent's Estates (0 Environmental [OInsurance 0 Labor [J Local Government [Real Property [securities OTax Tot tigation (including 0) Utites Regulation Clothe catagory not sted negligence) 11. During 2019, were you a licensed professional (other than an attomey) or id you provide consulting services Indnidually or 334 amb of a professional assoc ation for which you charged or were paid over $10,000% Ores an oar or series Redon Tha SEX and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 12. re you or your ampere, ar any members of you Imada em, or ar amayers camer + cons b the tate board or agency ith which yo ar o wil be associated or + regulated by th Sate beard a agency with which you ar o wil bs asada or rn it Oa rr ty [Yes (INo (tagsiatoriuicial Offer - You ar ot required to complete this uestion yu are ling because Yo are a eit o 3 kel ocr or you rs Hi a 4 oppomcn ts ne of hs Name of Employer Type of Relationship Gt appicabiey Cicansing, Regulatory, Business) 13. Have you or a member of your mmedats family boa registered 25 3 bey o boy pena win he 12 ores receding vor fh of os forms Ove mf Name of Labbyint Lobbyists Princpal Dare of Regiatration Region | "Seption Other Disclosures — } 15. During 2019, after you were applied, ampeyed,o led o were nominated a2 conan, 4d you = receive any "g()"exceaing 200 par curr fom person or group of persons actin toga, hen bth you and thos person(s) were outside North Carona, + under circumstances tot wold lead essanabe person to conde the gifs were given for abbying? To answer Yes, al tree condition must apy. Ove a6 > not report is given by members of your extended foi 00 ot report its you hav previously reported on the pense Report for Exempted Persons. Ee — Name and Address of Donor(s) | Describe Item Received [Fr] The SEE and any attachments, excluding the Confidential Form, are public records. Page7or10 15, During 2015, after you were appointed, employed, or fled or were nominated a5 candidate, dd you + accept “scholarship” exceeding $200 relate to your public positon from a person ar group of persons acting together, + when those person(s) were outside North Carolina? To answer Yes, both conditions must app. A scholarship” is a grant-in-id, ither direct or Indirect, to attend a conference, meting, or similar event, including tuiton, raval, odging, mesle, and other similar expenses. Yes CINe (fl Offer - You ae not requred to comple ths question you are a judicll office or you are fing 0 a Judicial aficer sppoinie. > D0 not report its you have previously reported on the “Expense Report for Exempted Persons.” > Legisators are not required to report scholarships paid by a nonpartisan legislative organization of which the legislator or the General Assembly 1 3 member, partcpant, o afiate Date of | Name and Address of Bonor(s) Estimated Market Scholarship Value 16. Have you been appointed or considered for appoint to covered board by the Governor or another Cound of State member? Council of State members are: > Governor > Le Governor > Secretary of Sate > State auditor > State Treasurer > Superintendent of Public Instruction > Attorney General > Commissioner of Agriculture Commissioner of Labor > Commissioner of Insurance Oves 1 “Yes, ist 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 NCGS. 163-278.6(6) and include any advance, conveyance, depos, distribution, transfer of funds, Ian, payment, 0, pledge or subscriten of money or anything of value. whatsoever. Date Amount Contributed to CINo contributions) with cumulative total of more than $1,000 The SET and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 17. you i appantes or prospective apples an a. te head of a principl sate depariment e.g. cab: secretory) sppoted oy 5. a North Carolina Supreme Couet utc, Court of Appeals, Superior or District Coun ude or a member of any of the follwing boars: Ove rbe + hec commissan IF No, proceed to question 16. + Constl Resources Commission + Stte Board of Education + State Board of Electors + Otvsion of Empoymen Security + Environmental Management Commission + Industral Commission + Human Resources Commission + Rules Review Commissan © Bowraof Transportation + Utites Commision + _ Wife Resources Commission a. 1 50, were you appointed or are you beng considered for apparent to hat | ves [Ie postion by Counc 1 Soe mempers a ait ef so, you must ndcate whether dung 2059 you engaged n any of the following actives wih respec t or on bahalf of the Candis or cummin Commies of the Counc of Sate meres who spponcia you i Collected contributions rom multe conributors, too possession of such mulile contributions, and transfered or ddered ieee. ctessed Contrutions a the corte or comes I. Hosted funcrarsr at your residence o place of business” Dves Ovo Wh. Voluteered fo campagn-relted aces, incuding phone barks, eves assistance, Mallngs, Canvassing, Seng o any Ser acini sek |) ¥es CIN advances ina ompoign of 8 andre? 10. Have you ever been convicied of a eony for whch you have ne received she: () pardons o (1) an are of Ove wf [mms [outeof Conviction | county of Conviction | state of Conviction 19,76 you re of any oer information hat you elev may 355 he ies Comission In Sawa ou CORCemIng your compan wih he Se Covermmnen Eee ets Bes [IN if yes, please provide that information below. My mala ues o malay of wy household. She transition on 49-2010. tec estate renuns Geen: Tan inthe prouss of hons- Dering hee real estat as ker greading: The SEX and any attachments, excluding the Confidential Form, are public records. Page sor 10 he information provided n Uv Statement of Economie terest and ay attachment ar rv, complete, and acute oe sao oy eno an se ave no trons, nd wil no arte, ay ase, ners, o propery forthe purpose of canceling I rom nase ve aay a enone mere understand tat my Statement of Economic teres and any attachment xcept for the Contr Frm regarding i St have read and understand the flowing sats: A fing gas who nowy concels or kningly fa odie frat tha recur ob dosed a Se rt ft a Sianome MCG. § 1304.27. Penaty for tise formation. Ain parson who roids ls formation a satmen of economic tet... rowing that the oat 8 5 yo 3 Cie os ee RS Xai under penalty of pariury that the foregoing is true and correc, 4. 5- 8019 nl pe Bovey A Suet Prec NT DE ————————— The SEE and ay atachmmats, sxcuding the Comma For, ar pabli record Page 10010

For. E = iN szRECEIVED hie STATE ETHICS COMMISSION APR - 5 2018 (A) % JF Jj) 2019 STATEMENT OF ECONOMIC = THI MISSION R&P MENT oF we STATE ETHICS COM FE ovo gran This entire form must be completed to fulfill — bility hor 5 AW Your ethics filing obligation. ncompoe as, oe Ob Sb Supp. sant date. by L Supp. ecaed ame fe —— [profx [rirstnome [widdloname [osmame [sum | [Booey | A [Swdek ~~ | | fe oo es neh yoo see satu o are beng considered Adwine¥ative Office of the Coudg Cioverrers Crime Commission I I 'n._Do other immediate family members reside in your household? Mes Ono on this form, "Immediate fami” includes your spouse (unless legally separated). It fo ncudes members of your handed fry (your and your sp0uEes hirer, Grandin, parents, orandparents, and A5ings, and the Spouses oF enc of those persons) who reside In your ousehld. mancpated by marmage, enment in he US mika. o Cot order fo emancipation. Fre ‘Emancipated Minors = [Rouge Hota, Daughlee | Student [Studer [Shudany | The SEX and any attachments, excluding the Confidential Form, are public records. Page 1.f 10 st only the ftiats of al unemancioeted minors n your housenold blow. A mina 13 3 cid under 18 years old. List the full name of each mine child on the Confidential Form at the end. unemandpated Property Interests I of December 31, 2018, ad you or any members of your immediate fami: A. have an ownership interest in North Carolina ea state (including your residence) with a market value of £10,000 or more? elves Ono [owner of meat estate | 9 Ownership Interest | Location by city | _ Location by County _| lease or rent rea estat o personal property o from the Sate of Noth Carolina wih 8 market value of $10/500 or more? Ove mf If Real Estate Location | If Personal property, by City & County Describe 2 A any Smo during 2017 or 2018, dd you or any members of your immediate fami sll 2 or buy from the Sate of North Carolin personal propery worth 10,000 or more? Oves oo [ Wamoorpuchsser | Namoorseer | Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20r 10 3s of December 31, 2018, did you or any members of your Immediate family own any of the following financial (haress values at $10,000 of more? List each company Individually. A. Stock i a yi owned company? Ove [fe 0 bat ist nerests Tn 3 widely held Investment and (ncluding mil Fonds, regulated Investment companies, or pension o deferred compensation plans te un 5 ull traded o a saets are widely diversified; and 2. nether you nor an immediate family member are bie t contr the underlying assets. [ ownerofmmersst [Full Name of Company or ticker symbol 5. Stock options n a company or business? Ove who “Owner of Stack option Full Name of Company (Do not use a ticker symbol) ineress 17a ron publ owned company or business enty? These Include teres I sole popretorsnps, Davinerahpe, Imad partharanss, Jot ventures, mid Iabiiy companies, ited ably pornersnps, and Cosel held corporations. ives fo - 1 °No,” proceed to question 4. [CC ownwormmeres | Name of Company or Business Entity C (1). For each company or business entity Identified in question 3.C. (the “Primary Company”), please list | ive mes of ny othr Companies or snes enies 1 whic the Primary Company oars secures or | uy eres valued o ove $10,000, f known | ‘Non-publicly Owned Company or Business Entity | _ Other Companies in which the Primary Company (Eho primary Company) “Owns Security or Equiy Interests The SEI and any attachments, excluding the Confidential Form, are public records. Page3 of 10 (2) 1F you know tha any entity sted In 3.C or 3.C(1) above has any matenal business dealings o business contracts with the State of North Carolina, or 1 regulated by the State, briefly describe that business activi. ‘Name of Company or Business Entity Description of Business Activity with the State 4 a of December 31, 2018, were you or any members of your Immediate family the beneficiaries of a vested trust wii Value of $10,000 or more that you created, estabished, or controlled? Do no list assets held in bind trusts. See 2019 SEI Helofu igs. for the defntion of "Vested Trust” and "BING Truk” Ove @%_ Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. hs of December 31, 2018, dd you any members of your immediate family have abies of $10,000 or more, excluding the mortgage on your primary personal rescence? Examples include credit card debts, auto loans, student loans, persona oans and ra family debt. wes Oto ‘Name of Debtor | Type of Creditor (commercial Bank, credit union, Nocth Checlina Ste ployees Credit Uirigm, individual, etc.) &. List each source of Income (not specific amounts) of more than $5,000 received by you or any members of your immedate family curing 2018. Include salary, wages, state/local goverment retirement income, professional fees, onorana, Interest, dwidends, rental Income, Business Income, and other types required to be reported on State and fodaral ta returns. 00 not include income received from the folowing sources: > Capial gains > Federal government retrement > wilkary retirement > Social security income/SSD1 Recipient of Income Type of Type of income Business / Industry had no reportable income over $5,000 in 2016. 20 R The SEE and any attachments, excluding the Confidential Form, are public records. Page a of 10 Professional and Civic Relationships 70a). During 2018, were you or any members of your immediate family a director, officer, governing board member, payee, independant contrattr,o re0ster dobby of & onproft. corporate o ganzaton operating in North Carlin grimly for relcious, har kable, aentinc, erry, pubic neath and safety, o educational purposes? ves a ns > Bo rot at State boards or enies. > Do not st organization of which you are a mere member. Dont ist organizations of which you are a ere member. Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 700). If the nonprofit corporations or organizations sted above do business with the State of North Carolina or receive State unde briefly describe the naturs of hat business, f Known or with due dgence could reasonably be known Name of Nonprofit Corporation or Organization Describe stats Business Bung 2016, were you or any members of your [mediate Family 3 drecir, oFicer, or Govering board member of any Society, organization, o SAUGCACY roup with an Interest In matters over which Your agency ar board may have Junsdcton O¥es @Ro [JLegisiator/ludcil Officer -You are not required to complete this question f you are filing because: Vou are a eqsitor o Judicial officer or you are fing 25 an appoIntes to on of hose offices »00 not ls organizations of which you are only @ member and do not seve n a leadership role. ‘Name of Society, Organization, Leadership position or Advocacy Group (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Pages of 10 FT py —— Probe il optus Suto ha By oy FrT— rE Se oars eae oem ame of Company or Business Entity [op my — [Not applicable (No entities listed on #9a) Frye rym—— [Oves [No (fSudicial Ofcer/State Attormey Iva" check enc category olga representation which yoo he aw rh with whch yo ar afflted has aad Heo ets of ar hom $30,500 ony Sov [ETI samy [Er Dormer JEa— EI— Cinsurance Citar P— Dives propery secures rex fon itgton (dung ies Regulation CJ ther category na sed negligence) T+ During 2018, were you 3 Weresd profesional (ahr an 37 arma) or 04 you provide Cred serves ee aa SS resto ET — Rare of Soria Rondars The SEZ and any atachmants, excluding the Confidential Form, are public records. vagesorin 12. Ae you or your employer, o any members of your immediate family, or ther employers curently: + lensed by the State board or agency with which you ae or wil be associated or + regulated by the State board or agency with whch you ar or wil be associated or + in business relationship with the State board or agency with which you ar or wil be associated? [J¥es [INo (@Rgitator Judicial Officer - You are not required to complete this question f you are fing because Vou are a egsiator o a udcial office or you are fing a5 an appointee to on of hose offices. ‘Name of Employer Type of Relationship (applicable) (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or 19bbyst principal within the 12 months preceding your fling of t's form? Ove Mo Lobbyist's Principal Date of Registration Registration Expiration Other Disclosures 16. During 2018, after you were appointed, employed, or led or were nominated as a candidate, did you | + receive any "git(s)" exceeding $200 per quarter rom a person or group of persons acting together, | « when both you and those person(s) were outside North Carolia, + under circumstances that would lead a reasonable person to conclude the gifts were given for lobbying? | To answer ves, all three conditions must apply. | Sy 55 not report ts ven by members of your extended family. > 00 not report gts you have previousy reported on te "Expense Report fo Exempted persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received Value The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2018, ser you ware applied, amplyed, or ed or were minted 2. cant, 4 You acca a “scholars exceading $200 rete to your publ posit from a person or Group a PRON acing ne, + when hos person(s) were atid North Carina? 7o answer Ys, oh conditions must 859. A “scholarship” i a arant-in-aid, sither direct o indirac, to stand conference, meeting, or similar soy ion raves ding rests ond sear Slr axpomSes, SA SE RE Se Ping 2 tcl oer apportes. > Do not report ts you have previa reported on the “Expense Report or Exempted persons.” Lecisatos are no required t report scholarships pa by a rngarian eilaive oganzaton of whch th estar oe Comers Asem sa marr, papa, or ae. Date of ‘Name and Address of Donor(s) Schatarenin 6. Hove you been aspired or considered or sopoTen 3 covered board by he Gaver a anther Cound of ee emer Council of State members ae: > Governor rp— > Secretary of ste > State utr » Sate Treasurer > Superintendent of Puc Insirucion > Acorey Genera » Commissioner of Agricture ~~» Commissioner f Labor > Commissioner of Insurance Ove he 1rYas, list al contributions you mad in 2018 with cumulative tata of mora than $1,000 to the Council or Sears marmmer wi ppotNied ou. 50 not includ Sortsitions from immediate fay members: » Contributions are defined road in CG. § 63A-1411(13) nd nce “any acvanc, conveyance, Geos, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value fre | [ome [mom | Contributed to ] hc comrion(s wih a comets total of mare an $1,000 The SEE and any attachments, excluding the Confidential Form, are public records. Pages ori + State Board of Education Clves [INo i vosted a fundraiser at your residence or lace of business? [Ove Ow | es othe [oes | oatoof conviction | County of Conviction | _ State of Conviction nm The information provided in this Statement of Economic Interest and any atachments are rue, complte, and accurate the best of my knowledge and belle 1 have not vansterred, and wil not transfer, any asst, interest, or propery for the purpose of concealing t from closure whi reining an equitable Interest 1 understand tha my Statement of Economic Interest and any attachments excep or the Confidential Form regarding Unemancpated Chien are publ records. 1 have read and understand th following statutes: N.C.G.S. § 1634-191. Concealing or failing to disclose materia Information. A filng person who knowingly conceals or knowingly fais to discose information tha i required to be disclosed on'a Satement of economic teres shall be Gul of a Class 1 misdemeanor and sujet to discinary Seton under 6.5. 1638-415 NCGS. § 1634192. Penalty for flse information. A fling person who provides ase information on statement of economic interest... knowing tht the Information 1 a's 1 gulty of 8 Class felony and shall be subject to disciplinary action under G.5. 1634-415. Laff tha have reviewed my most recently fled 2018 Statement of Economic Interest and tha as of December 31, 2615, my responses continue to be ru, correct, and complet to the best of my knowledge and belie. 1 affim under penaiy of perjury that the foregoing i true and correct. 2 VO 3-1-2084 amature Er— Do ASoutl Submit signed, original documents only. Do not fax or e-mall this form. 1 The SE and any attachments, excluding the Confidential Form, are public records. Page 10.0f 10

reseed "ECE 5D) " jsbebintis or STATE ETHICS COMMISSION APR - 5 2019 sl 7 0 eli 8/5) 2019 STATEMENT OF ECONOMIC STATE ETHICS COMMISSION = INTEREST fio for completion This entire form must be completed to fulfill scammed LL ows Your ethics filing obligation. ome Surg. snk te o Pr re—— Enared database by [Beery | A [Sodetd [| [Sere of Nodh (ugliny | Diokridt Gust Jude | ’ ow vo ars Saving oar beng Condres hrct Cou Jude __ A. Do other immediate family members reside in your household? Oves Oe On this form, “immediate fami” includes your spouse (unless legally separated). I alo ncudes members of your extended fai (your and your spouse's hicren, arandinlen, parent, randparents, and Soinge, and ih Spouses oF cach of thos persons) wh reside in your household. emancipated by mariage, entetmen in he US mir or cour over fo emancipation Er a emancipated Minors 8 - PooyW. Stet [Mother [Reked [Reled — [Kekied | The SEE and any attachments, excluding the Confidential Form, are pubic records. Page 1.f 10 List only the initials of all unemancpated minors n your household below. A minor 15 3 chid under 18 years 0. List the ful name of each minor child on the Confidential Form at the and. unemandated Property Interests 1. As of December 31, 2018, id you or any members of your immediate family: A. have an ownershi interes n North Carolina rea estate (including your residence) with a market value of $10,000 or more? @Yes Ono | Owner of Realestate | 9% Ownership Interest | Location by city Location by County _| [See Ato | | 8. lease or rent real estate or personal property o o rom the State of North Carolina wih a market value of $10,000 or more? | Oves [fo | If Real Estate, Location | If Personal Property, by City & County Describe. 2. At any time during 2017 or 2016, did you or any members of your immediate fami sell or buy from the State of North Carolina personal property worth $10,000 or more? Ove wo [Nameorpuchaser | Namoorsater | Type of Property The SEZ and any attachments, excluding the Confidential Form, are public records. Page 20f 10 3. As of December 31, 2018, did you or any members of your immediate family own any of the folowing financial Pkeress valued at $10,000 or more? List each company individually. A. Stock n 2 pudicy owned company? [ves fo 50 at lst ntvests n 3 widely held investment fund (ndiuding mutaal nds, regulated Investment companies, or pension or defered compensation pian) 1: the fund publicly traded o KS assets are widely diversified; and 2. nether you nor an immediate family member re sbe to control the underlying asset. [ ownerofmteest [Full Name of Company or ticker symbol ©. Stock options n 2 company or business? Ove 6 Full Name of Company (00 not use a ticker symbol) C. Interests in a non-publicly owned company or business entity? These include interests in sole proprietorships, Bartnersips, Imad partners, Ji ventures, Imied ably companies, imited abilty partnerships, and Cosel held corporations. ves C946 "No. proceed to question 4 I SE Name of Company or Business Entity (1. For each company or business ent dented In question 3.C. the Primary Company”), lease st. he names of any othe companies ar Dusiness enies In which the Primary Company owns secures or uy ncerests valued a over $10,000, I know, Non-Publicy Owned Company or Business Entity | _ Other Companies in which the Primary Company (Ene primary Company) ‘Owns Security or Equity Interests The SEE and any attachments, excluding the Confidential Form, are public records. Page 30r10 C1 1 you know ha any entity 5204 1 3.C or 3.611) shove has any material business delngs o business Coracts ith th State of North Carine, o 1 Fpdate b te Sate ey Gescnbe tha Busnes scivey. Name of Company or Business Entity Description of Business Activity with the State As of December 31, 2018, war you or any members of your Immediate fay th beneficiaries of vested trust with Value of $10,000 or more sha you irene, esabrsned,o Controlled? D0 na st asets hei in bind trusts. See 2019 SEL lol To or the dafiotion of “Vested Trust” and “Bld Tus” Ove Nama and Address of Trustes Description of the Trust Your Relationship tthe Trust 5. 7 of December 31, 2018, id you any members of your immediate fay have abies of $10,000 0 more, &xdng he mortgage on Your pAmary parton! reSGencey EXemPES Include (raat Card Ges, sts 000s, Sent loa Personal tans and mrs any So es Ono Nemeotoebr Type of Creditor (commercial Bank, credit union, North Cais. Giole. Eneloeto Coed (un | Credit Ug. indivdun, te) Lt each source of come (not specific amounts) of more than $5,000 receved by you o any members of your immediate family ing 2015. Incude salary: Whoes, Sat ocs qoverman Tcreman Income, professane fs, Ronoraria, tars, Gwidend, renal Income, Gusness Income, and othr pes requir 0b resoed on Se and federal ox rus. D0 not includ income recewed rom th following sources: > Capra gans » Federal government retrement > Miter resrement > Social secuty income/SsO1 Recipient of Income Type of Type of Income Buiness/ Industry 71700 mo reportable income over $5,000 m 20. The SEE and any attachments, excluding the Confidential Form, ars public records. Page aor10 Professional and Civic Relationships 708). During 2015, were you or any members of your Immediate family 3 director, officer, governing board member, employee Independent contractor, a recisared obbyiS of 8 nonprofit. Corporation of rg anEaton operating in Noh Carolina primary for recous, chankae, sent, Werary, pubic heath and Safety, or eGucatonal purposes Oves es 1£"No,” proceed to question 8. > Bo not Te Sate boas o anes. > Do not st organizations of which you are mere member, Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 705). 1 the nonprofit corporations or organizations sted above do business with the State of North Carolina or receive State funds, briefly describe the nature of hat business, f Known o wit de ali gence could reasonably be known. Name of Nonprofit Corporation or Organization | Describe Stato Business | None or Not Known J During 2016, were you or Sv members of your Immediate amy 3 drecir, officer, or Govering board member of any sodety, arganiiaton, or Avecacy group With an IXeres In maters over which Your agency or board may have Sons? [Ves CIS Cagis ucical Ofc ou ars nok requred to complete ths uestion you are fling because are a leiiaor or cil Officer or you are ng a5 a 3pPOes 10 one o those oMfces. 00 not Ist organizations of which you are only a member and do nok serve I a leadership ole. Name of Society, Organization, Leadership Position or Advocacy Group (Director, Officer, Board Member) The SEX and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 SU, Ut th mame of ex Busnes wh whieh vou were ssoced where va o 3 ember of our made ay a avayec Gear ar pane, opREDr a memDSN of manager 35 of Decemoer 35, S018 | Mame of person | melatonship to rier | Name of Company | ole of Person _| 5X0. you Know Gat any nity Ted 5a) above ad amy mataral buses dealings or business contac wih te eof arth Cara or os vce th Sto of Detemoe Sos S016, Gay deserts st ac Name of Company o Business Entity Description of Business Acivity with the State Re aplcable (to anes sted on #92) TT — ves CIN. (tcl Offcerstats Attorney 1 Ves, check each category of aga rsresaraton in whch you oth i rh with which you are aia has eamed lego fee of more han 10,00 Gung 3016. DS ramisratve Cinema Dcarporate Dcommt Cloecedents estates Onvronmenta insurance Oator local Governmen rea roerty secu Oe Tort gation (ncuding [Unites Regustion 3 Cxhr category ot sted neigence) I. During 1015, were ves 2 eaneed pafestoral (oar ha ar Soro of G4 You prove CTS serves nivadiaty of 33 mr oF a rfasaorat sessaton fo wh ou Corie of wire Pod ovr $1000 wy Type of Business Nature of Services Rendered The SEX and any attachments, excluding the Confidential Form, are public records. Pagesor10 12. Ave you o your employer, or any members of your immediate fami, o their employers currently: licensed by th Stae board or agency with whch you are or wil be associated or regulated b the State board or agency with whieh you ae or wil be associted or + in business reatpnsp ath the Sate board ar 39ency with which you are or wil be associated? Five C1 ogsitaiudnt Off tot rt erred campeon you se tgs you are legitor or a judicial officer o you are fing 2 an appointee to one of hose afice. Nome of Employer Type of Relationship Gf applicable) (Licensing, Regulatory, Business) 3. Rave you or a member of your Immediate family been registered a5 8 IoBbyISt or lobbyist principal within the 12 months preceding your lng of this form? Ove tho Name of Lobbyist Date of Registration Registration Expiration 16. During 2018, ater you were appointed, employed, or fled or were nominated 0s a candidte, 4d you receive any "9t(s)" exceeding $200 per quarter from person or group of persons acting together, + When both you and those person(s) were outside North Carolina, + under crcumstances tha would ead a reasonabe person to conciude the ts were given for lobbying? To answer Yes, ll three conditions must app. Ores Se > Bo not report gi given by members of your exended ary. > Do not report its you have previousy reported on the "Expense Report fo Exempted Persons.” ‘Name and Address of Donor(s) | Describe Item Received [enim] The SEE and any attachmants, excluding the Confidential Form, are public records. Page 7 af 10 15. uring 2018, ater you were appointed, employed, or fled o were nominated as a candidate, dd you + accept o scholarship® exceeding $200 related to your publ postion from a person or group of persens acing togetner, + when those person(s) were ouside North Carolina? To answer Ye, both conditions mst apply. A “scholarship” is a grant-in-aid, ither direct or indirect to attend a conference, mesting, or similar event, including fuition, travel, lodging, meals, and other similar expenses. [Yes [Io (rSidical Officer You are not required to comple tis question you are a Judicil officer or you are: filng asa judical oficer sppoinice. > D0 not report gis you have previously reported on the Expense Report for Exempted Persons.” > Legislators ae not required to report scholarships paid by a nonpartisan legislative organization of which th legislator or the General Assembly 1s 8 member, participa, o afflate. Date of Name and Address of Donor(s) Scholarship 16. Have you been appointed or considered for 3ppaNME to 8 covered board by the Governor or another Councl of State member? Council of State members are: > Governor > Lt. Govemor > Secretary of State > State Auditor > State Treasurer > Superintendent of Public Instruction > tomy General > Commissioner of Agriculture» Commissioner of Labor > Commisioper of Insurance Oves 1 “Yes, list all contrbutions you made in 2018 with a cumulative total of more than $1,000 t the Council of Stata member who appointed you. Bo not include contributions from immediate family members. > Contributions are defined broadly In N.C.GS, § 163A-1411(13) and ncude “any advance, conveyance, depos, stiution, transfer of funds, loan, payment, Gi, pledge or Subscription of money o anytning of value Whatsoever.” TT Cones WN contrbution(s) with 8 cumulative tal of more than $1,000 The SEL and any attachments, excluding the Confidential Form, are public records. Page sor so Te Tr SA po Te a the hed of 3 prio sate dpariment (3. cabinet secraary) appaned by he ahh . amemberef any of the folowing boards: ac Commssn + Coastal Resources Commission rho + State Board of Education Oves No Se bod of Becton ~ Onision of Employment Securty 3 No process to Envronmaralaragemers Camisson Question 18. Indust Commission ~ aman Resa Commision Rte Reem Comms + rt wermoraton © IRC aaardof Govemors ~ nites Common © Vite Resources Commission oT, wars you sponte or are yw ba eradred or spa ot Eves IN Seon oy Come of av mame’ Bre DY ueston 18. © 50, you must nate whether during 018 you eng99e3 many of he allowing ie Teak oor oh Bea of Comoro cap somes of a Conn of See meron whe spare go 1 Callcted contributions fom mull contributors, ak possession of such ime conmootons pa ao Sve ro eoeen onion to he inaasa r commeet 1. Hosted fundraise a your residence or place of business? [Ove Ome | W- Volatesed for campaigned seit, Including phone barks, ever re campaign of scone 5 ave vou ever ben convicted of any for wh you have ot recaved others () perder; or 1 on order of Fa Oves No [ ofews | ower conviction | Cony of Conviction | state of Gomaiion 5 eyo are of a oe formation hat yu Dleve may St the Es Commision no ou crn vo cmphance we Se Govan Sens SEP The SEE and any attachments, excluding the Confidential Form, are public records. Pagesorso The formation provided in tis Samet of xonomic Interest and any aachments ae re, compete, and crate ne em of my powidge ond Sle have not ransered, and wil nt transfer, any asst, interest, o propery for the purpose of concesing ft fom Gncionre whe remiing an suai meee. 1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding Unemancpates Coven se pose rca, have read and understand the follwing states: NC.G.5. § 1634-191. Concealingor fang to disclose material information A fing person who knowingly cones o knowingly fal to discos Information tht i recurs to be discosed on Satamant of eno eres shall oe ly of 5 Coc SG and Sp Spy ven nie 05, Semis. NCGS. 5 1630192. Panay for ls formation A fing person who provides fase formation an statement of economic rest knowing tht the Iormaton 5 (se 1 Guy of 8 las felony and Sha be Sbjct 15 nc acon andes re: ESA415. Laff th 1 have reviewed my most recenty fled 2018 Statement of Economic Itaest and tha a of December 21, 2018, my responses contin t be rue, COC, nd comets ie best of my knowiedge ad sere Xaffim under penalty of perjury thatthe foregoing is trus and corect. 311-2011 mature Bate Borda A. Seaub- Printed va Submit signed, original documents ony, Do not fox or e-mail his form. The SEL and any attachmants, axcluding the Confidential Form, are public records. Page 100110

For. E = iN szRECEIVED hie STATE ETHICS COMMISSION APR - 5 2018 (A) % JF Jj) 2019 STATEMENT OF ECONOMIC = THI MISSION R&P MENT oF we STATE ETHICS COM FE ovo gran This entire form must be completed to fulfill — bility hor 5 AW Your ethics filing obligation. ncompoe as, oe Ob Sb Supp. sant date. by L Supp. ecaed ame fe —— [profx [rirstnome [widdloname [osmame [sum | [Booey | A [Swdek ~~ | | fe oo es neh yoo see satu o are beng considered Adwine¥ative Office of the Coudg Cioverrers Crime Commission I I 'n._Do other immediate family members reside in your household? Mes Ono on this form, "Immediate fami” includes your spouse (unless legally separated). It fo ncudes members of your handed fry (your and your sp0uEes hirer, Grandin, parents, orandparents, and A5ings, and the Spouses oF enc of those persons) who reside In your ousehld. mancpated by marmage, enment in he US mika. o Cot order fo emancipation. Fre ‘Emancipated Minors = [Rouge Hota, Daughlee | Student [Studer [Shudany | The SEX and any attachments, excluding the Confidential Form, are public records. Page 1.f 10 st only the ftiats of al unemancioeted minors n your housenold blow. A mina 13 3 cid under 18 years old. List the full name of each mine child on the Confidential Form at the end. unemandpated Property Interests I of December 31, 2018, ad you or any members of your immediate fami: A. have an ownership interest in North Carolina ea state (including your residence) with a market value of £10,000 or more? elves Ono [owner of meat estate | 9 Ownership Interest | Location by city | _ Location by County _| lease or rent rea estat o personal property o from the Sate of Noth Carolina wih 8 market value of $10/500 or more? Ove mf If Real Estate Location | If Personal property, by City & County Describe 2 A any Smo during 2017 or 2018, dd you or any members of your immediate fami sll 2 or buy from the Sate of North Carolin personal propery worth 10,000 or more? Oves oo [ Wamoorpuchsser | Namoorseer | Type of Property The SEX and any attachments, excluding the Confidential Form, are public records. Page 20r 10 3s of December 31, 2018, did you or any members of your Immediate family own any of the following financial (haress values at $10,000 of more? List each company Individually. A. Stock i a yi owned company? Ove [fe 0 bat ist nerests Tn 3 widely held Investment and (ncluding mil Fonds, regulated Investment companies, or pension o deferred compensation plans te un 5 ull traded o a saets are widely diversified; and 2. nether you nor an immediate family member are bie t contr the underlying assets. [ ownerofmmersst [Full Name of Company or ticker symbol 5. Stock options n a company or business? Ove who “Owner of Stack option Full Name of Company (Do not use a ticker symbol) ineress 17a ron publ owned company or business enty? These Include teres I sole popretorsnps, Davinerahpe, Imad partharanss, Jot ventures, mid Iabiiy companies, ited ably pornersnps, and Cosel held corporations. ives fo - 1 °No,” proceed to question 4. [CC ownwormmeres | Name of Company or Business Entity C (1). For each company or business entity Identified in question 3.C. (the “Primary Company”), please list | ive mes of ny othr Companies or snes enies 1 whic the Primary Company oars secures or | uy eres valued o ove $10,000, f known | ‘Non-publicly Owned Company or Business Entity | _ Other Companies in which the Primary Company (Eho primary Company) “Owns Security or Equiy Interests The SEI and any attachments, excluding the Confidential Form, are public records. Page3 of 10 (2) 1F you know tha any entity sted In 3.C or 3.C(1) above has any matenal business dealings o business contracts with the State of North Carolina, or 1 regulated by the State, briefly describe that business activi. ‘Name of Company or Business Entity Description of Business Activity with the State 4 a of December 31, 2018, were you or any members of your Immediate family the beneficiaries of a vested trust wii Value of $10,000 or more that you created, estabished, or controlled? Do no list assets held in bind trusts. See 2019 SEI Helofu igs. for the defntion of "Vested Trust” and "BING Truk” Ove @%_ Name and Address of Trustee Description of the Trust Your Relationship to the Trust 5. hs of December 31, 2018, dd you any members of your immediate family have abies of $10,000 or more, excluding the mortgage on your primary personal rescence? Examples include credit card debts, auto loans, student loans, persona oans and ra family debt. wes Oto ‘Name of Debtor | Type of Creditor (commercial Bank, credit union, Nocth Checlina Ste ployees Credit Uirigm, individual, etc.) &. List each source of Income (not specific amounts) of more than $5,000 received by you or any members of your immedate family curing 2018. Include salary, wages, state/local goverment retirement income, professional fees, onorana, Interest, dwidends, rental Income, Business Income, and other types required to be reported on State and fodaral ta returns. 00 not include income received from the folowing sources: > Capial gains > Federal government retrement > wilkary retirement > Social security income/SSD1 Recipient of Income Type of Type of income Business / Industry had no reportable income over $5,000 in 2016. 20 R The SEE and any attachments, excluding the Confidential Form, are public records. Page a of 10 Professional and Civic Relationships 70a). During 2018, were you or any members of your immediate family a director, officer, governing board member, payee, independant contrattr,o re0ster dobby of & onproft. corporate o ganzaton operating in North Carlin grimly for relcious, har kable, aentinc, erry, pubic neath and safety, o educational purposes? ves a ns > Bo rot at State boards or enies. > Do not st organization of which you are a mere member. Dont ist organizations of which you are a ere member. Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 700). If the nonprofit corporations or organizations sted above do business with the State of North Carolina or receive State unde briefly describe the naturs of hat business, f Known or with due dgence could reasonably be known Name of Nonprofit Corporation or Organization Describe stats Business Bung 2016, were you or any members of your [mediate Family 3 drecir, oFicer, or Govering board member of any Society, organization, o SAUGCACY roup with an Interest In matters over which Your agency ar board may have Junsdcton O¥es @Ro [JLegisiator/ludcil Officer -You are not required to complete this question f you are filing because: Vou are a eqsitor o Judicial officer or you are fing 25 an appoIntes to on of hose offices »00 not ls organizations of which you are only @ member and do not seve n a leadership role. ‘Name of Society, Organization, Leadership position or Advocacy Group (Director, Officer, Board Member) The SEI and any attachments, excluding the Confidential Form, are public records. Pages of 10 FT py —— Probe il optus Suto ha By oy FrT— rE Se oars eae oem ame of Company or Business Entity [op my — [Not applicable (No entities listed on #9a) Frye rym—— [Oves [No (fSudicial Ofcer/State Attormey Iva" check enc category olga representation which yoo he aw rh with whch yo ar afflted has aad Heo ets of ar hom $30,500 ony Sov [ETI samy [Er Dormer JEa— EI— Cinsurance Citar P— Dives propery secures rex fon itgton (dung ies Regulation CJ ther category na sed negligence) T+ During 2018, were you 3 Weresd profesional (ahr an 37 arma) or 04 you provide Cred serves ee aa SS resto ET — Rare of Soria Rondars The SEZ and any atachmants, excluding the Confidential Form, are public records. vagesorin 12. Ae you or your employer, o any members of your immediate family, or ther employers curently: + lensed by the State board or agency with which you ae or wil be associated or + regulated by the State board or agency with whch you ar or wil be associated or + in business relationship with the State board or agency with which you ar or wil be associated? [J¥es [INo (@Rgitator Judicial Officer - You are not required to complete this question f you are fing because Vou are a egsiator o a udcial office or you are fing a5 an appointee to on of hose offices. ‘Name of Employer Type of Relationship (applicable) (Licensing, Regulatory, Business) 13. Have you or a member of your immediate family been registered as a lobbyist or 19bbyst principal within the 12 months preceding your fling of t's form? Ove Mo Lobbyist's Principal Date of Registration Registration Expiration Other Disclosures 16. During 2018, after you were appointed, employed, or led or were nominated as a candidate, did you | + receive any "git(s)" exceeding $200 per quarter rom a person or group of persons acting together, | « when both you and those person(s) were outside North Carolia, + under circumstances that would lead a reasonable person to conclude the gifts were given for lobbying? | To answer ves, all three conditions must apply. | Sy 55 not report ts ven by members of your extended family. > 00 not report gts you have previousy reported on te "Expense Report fo Exempted persons.” Date Item Received | Name and Address of Donor(s) | Describe Item Received Value The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2018, ser you ware applied, amplyed, or ed or were minted 2. cant, 4 You acca a “scholars exceading $200 rete to your publ posit from a person or Group a PRON acing ne, + when hos person(s) were atid North Carina? 7o answer Ys, oh conditions must 859. A “scholarship” i a arant-in-aid, sither direct o indirac, to stand conference, meeting, or similar soy ion raves ding rests ond sear Slr axpomSes, SA SE RE Se Ping 2 tcl oer apportes. > Do not report ts you have previa reported on the “Expense Report or Exempted persons.” Lecisatos are no required t report scholarships pa by a rngarian eilaive oganzaton of whch th estar oe Comers Asem sa marr, papa, or ae. Date of ‘Name and Address of Donor(s) Schatarenin 6. Hove you been aspired or considered or sopoTen 3 covered board by he Gaver a anther Cound of ee emer Council of State members ae: > Governor rp— > Secretary of ste > State utr » Sate Treasurer > Superintendent of Puc Insirucion > Acorey Genera » Commissioner of Agricture ~~» Commissioner f Labor > Commissioner of Insurance Ove he 1rYas, list al contributions you mad in 2018 with cumulative tata of mora than $1,000 to the Council or Sears marmmer wi ppotNied ou. 50 not includ Sortsitions from immediate fay members: » Contributions are defined road in CG. § 63A-1411(13) nd nce “any acvanc, conveyance, Geos, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value fre | [ome [mom | Contributed to ] hc comrion(s wih a comets total of mare an $1,000 The SEE and any attachments, excluding the Confidential Form, are public records. Pages ori + State Board of Education Clves [INo i vosted a fundraiser at your residence or lace of business? [Ove Ow | es othe [oes | oatoof conviction | County of Conviction | _ State of Conviction nm The information provided in this Statement of Economic Interest and any atachments are rue, complte, and accurate the best of my knowledge and belle 1 have not vansterred, and wil not transfer, any asst, interest, or propery for the purpose of concealing t from closure whi reining an equitable Interest 1 understand tha my Statement of Economic Interest and any attachments excep or the Confidential Form regarding Unemancpated Chien are publ records. 1 have read and understand th following statutes: N.C.G.S. § 1634-191. Concealing or failing to disclose materia Information. A filng person who knowingly conceals or knowingly fais to discose information tha i required to be disclosed on'a Satement of economic teres shall be Gul of a Class 1 misdemeanor and sujet to discinary Seton under 6.5. 1638-415 NCGS. § 1634192. Penalty for flse information. A fling person who provides ase information on statement of economic interest... knowing tht the Information 1 a's 1 gulty of 8 Class felony and shall be subject to disciplinary action under G.5. 1634-415. Laff tha have reviewed my most recently fled 2018 Statement of Economic Interest and tha as of December 31, 2615, my responses continue to be ru, correct, and complet to the best of my knowledge and belie. 1 affim under penaiy of perjury that the foregoing i true and correct. 2 VO 3-1-2084 amature Er— Do ASoutl Submit signed, original documents only. Do not fax or e-mall this form. 1 The SE and any attachments, excluding the Confidential Form, are public records. Page 10.0f 10

reseed "ECE 5D) " jsbebintis or STATE ETHICS COMMISSION APR - 5 2019 sl 7 0 eli 8/5) 2019 STATEMENT OF ECONOMIC STATE ETHICS COMMISSION = INTEREST fio for completion This entire form must be completed to fulfill scammed LL ows Your ethics filing obligation. ome Surg. snk te o Pr re—— Enared database by [Beery | A [Sodetd [| [Sere of Nodh (ugliny | Diokridt Gust Jude | ’ ow vo ars Saving oar beng Condres hrct Cou Jude __ A. Do other immediate family members reside in your household? Oves Oe On this form, “immediate fami” includes your spouse (unless legally separated). I alo ncudes members of your extended fai (your and your spouse's hicren, arandinlen, parent, randparents, and Soinge, and ih Spouses oF cach of thos persons) wh reside in your household. emancipated by mariage, entetmen in he US mir or cour over fo emancipation Er a emancipated Minors 8 - PooyW. Stet [Mother [Reked [Reled — [Kekied | The SEE and any attachments, excluding the Confidential Form, are pubic records. Page 1.f 10 List only the initials of all unemancpated minors n your household below. A minor 15 3 chid under 18 years 0. List the ful name of each minor child on the Confidential Form at the and. unemandated Property Interests 1. As of December 31, 2018, id you or any members of your immediate family: A. have an ownershi interes n North Carolina rea estate (including your residence) with a market value of $10,000 or more? @Yes Ono | Owner of Realestate | 9% Ownership Interest | Location by city Location by County _| [See Ato | | 8. lease or rent real estate or personal property o o rom the State of North Carolina wih a market value of $10,000 or more? | Oves [fo | If Real Estate, Location | If Personal Property, by City & County Describe. 2. At any time during 2017 or 2016, did you or any members of your immediate fami sell or buy from the State of North Carolina personal property worth $10,000 or more? Ove wo [Nameorpuchaser | Namoorsater | Type of Property The SEZ and any attachments, excluding the Confidential Form, are public records. Page 20f 10 3. As of December 31, 2018, did you or any members of your immediate family own any of the folowing financial Pkeress valued at $10,000 or more? List each company individually. A. Stock n 2 pudicy owned company? [ves fo 50 at lst ntvests n 3 widely held investment fund (ndiuding mutaal nds, regulated Investment companies, or pension or defered compensation pian) 1: the fund publicly traded o KS assets are widely diversified; and 2. nether you nor an immediate family member re sbe to control the underlying asset. [ ownerofmteest [Full Name of Company or ticker symbol ©. Stock options n 2 company or business? Ove 6 Full Name of Company (00 not use a ticker symbol) C. Interests in a non-publicly owned company or business entity? These include interests in sole proprietorships, Bartnersips, Imad partners, Ji ventures, Imied ably companies, imited abilty partnerships, and Cosel held corporations. ves C946 "No. proceed to question 4 I SE Name of Company or Business Entity (1. For each company or business ent dented In question 3.C. the Primary Company”), lease st. he names of any othe companies ar Dusiness enies In which the Primary Company owns secures or uy ncerests valued a over $10,000, I know, Non-Publicy Owned Company or Business Entity | _ Other Companies in which the Primary Company (Ene primary Company) ‘Owns Security or Equity Interests The SEE and any attachments, excluding the Confidential Form, are public records. Page 30r10 C1 1 you know ha any entity 5204 1 3.C or 3.611) shove has any material business delngs o business Coracts ith th State of North Carine, o 1 Fpdate b te Sate ey Gescnbe tha Busnes scivey. Name of Company or Business Entity Description of Business Activity with the State As of December 31, 2018, war you or any members of your Immediate fay th beneficiaries of vested trust with Value of $10,000 or more sha you irene, esabrsned,o Controlled? D0 na st asets hei in bind trusts. See 2019 SEL lol To or the dafiotion of “Vested Trust” and “Bld Tus” Ove Nama and Address of Trustes Description of the Trust Your Relationship tthe Trust 5. 7 of December 31, 2018, id you any members of your immediate fay have abies of $10,000 0 more, &xdng he mortgage on Your pAmary parton! reSGencey EXemPES Include (raat Card Ges, sts 000s, Sent loa Personal tans and mrs any So es Ono Nemeotoebr Type of Creditor (commercial Bank, credit union, North Cais. Giole. Eneloeto Coed (un | Credit Ug. indivdun, te) Lt each source of come (not specific amounts) of more than $5,000 receved by you o any members of your immediate family ing 2015. Incude salary: Whoes, Sat ocs qoverman Tcreman Income, professane fs, Ronoraria, tars, Gwidend, renal Income, Gusness Income, and othr pes requir 0b resoed on Se and federal ox rus. D0 not includ income recewed rom th following sources: > Capra gans » Federal government retrement > Miter resrement > Social secuty income/SsO1 Recipient of Income Type of Type of Income Buiness/ Industry 71700 mo reportable income over $5,000 m 20. The SEE and any attachments, excluding the Confidential Form, ars public records. Page aor10 Professional and Civic Relationships 708). During 2015, were you or any members of your Immediate family 3 director, officer, governing board member, employee Independent contractor, a recisared obbyiS of 8 nonprofit. Corporation of rg anEaton operating in Noh Carolina primary for recous, chankae, sent, Werary, pubic heath and Safety, or eGucatonal purposes Oves es 1£"No,” proceed to question 8. > Bo not Te Sate boas o anes. > Do not st organizations of which you are mere member, Name of Nonprofit Nature or Corporation or Organization | Purpose of Organization 705). 1 the nonprofit corporations or organizations sted above do business with the State of North Carolina or receive State funds, briefly describe the nature of hat business, f Known o wit de ali gence could reasonably be known. Name of Nonprofit Corporation or Organization | Describe Stato Business | None or Not Known J During 2016, were you or Sv members of your Immediate amy 3 drecir, officer, or Govering board member of any sodety, arganiiaton, or Avecacy group With an IXeres In maters over which Your agency or board may have Sons? [Ves CIS Cagis ucical Ofc ou ars nok requred to complete ths uestion you are fling because are a leiiaor or cil Officer or you are ng a5 a 3pPOes 10 one o those oMfces. 00 not Ist organizations of which you are only a member and do nok serve I a leadership ole. Name of Society, Organization, Leadership Position or Advocacy Group (Director, Officer, Board Member) The SEX and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 SU, Ut th mame of ex Busnes wh whieh vou were ssoced where va o 3 ember of our made ay a avayec Gear ar pane, opREDr a memDSN of manager 35 of Decemoer 35, S018 | Mame of person | melatonship to rier | Name of Company | ole of Person _| 5X0. you Know Gat any nity Ted 5a) above ad amy mataral buses dealings or business contac wih te eof arth Cara or os vce th Sto of Detemoe Sos S016, Gay deserts st ac Name of Company o Business Entity Description of Business Acivity with the State Re aplcable (to anes sted on #92) TT — ves CIN. (tcl Offcerstats Attorney 1 Ves, check each category of aga rsresaraton in whch you oth i rh with which you are aia has eamed lego fee of more han 10,00 Gung 3016. DS ramisratve Cinema Dcarporate Dcommt Cloecedents estates Onvronmenta insurance Oator local Governmen rea roerty secu Oe Tort gation (ncuding [Unites Regustion 3 Cxhr category ot sted neigence) I. During 1015, were ves 2 eaneed pafestoral (oar ha ar Soro of G4 You prove CTS serves nivadiaty of 33 mr oF a rfasaorat sessaton fo wh ou Corie of wire Pod ovr $1000 wy Type of Business Nature of Services Rendered The SEX and any attachments, excluding the Confidential Form, are public records. Pagesor10 12. Ave you o your employer, or any members of your immediate fami, o their employers currently: licensed by th Stae board or agency with whch you are or wil be associated or regulated b the State board or agency with whieh you ae or wil be associted or + in business reatpnsp ath the Sate board ar 39ency with which you are or wil be associated? Five C1 ogsitaiudnt Off tot rt erred campeon you se tgs you are legitor or a judicial officer o you are fing 2 an appointee to one of hose afice. Nome of Employer Type of Relationship Gf applicable) (Licensing, Regulatory, Business) 3. Rave you or a member of your Immediate family been registered a5 8 IoBbyISt or lobbyist principal within the 12 months preceding your lng of this form? Ove tho Name of Lobbyist Date of Registration Registration Expiration 16. During 2018, ater you were appointed, employed, or fled or were nominated 0s a candidte, 4d you receive any "9t(s)" exceeding $200 per quarter from person or group of persons acting together, + When both you and those person(s) were outside North Carolina, + under crcumstances tha would ead a reasonabe person to conciude the ts were given for lobbying? To answer Yes, ll three conditions must app. Ores Se > Bo not report gi given by members of your exended ary. > Do not report its you have previousy reported on the "Expense Report fo Exempted Persons.” ‘Name and Address of Donor(s) | Describe Item Received [enim] The SEE and any attachmants, excluding the Confidential Form, are public records. Page 7 af 10 15. uring 2018, ater you were appointed, employed, or fled o were nominated as a candidate, dd you + accept o scholarship® exceeding $200 related to your publ postion from a person or group of persens acing togetner, + when those person(s) were ouside North Carolina? To answer Ye, both conditions mst apply. A “scholarship” is a grant-in-aid, ither direct or indirect to attend a conference, mesting, or similar event, including fuition, travel, lodging, meals, and other similar expenses. [Yes [Io (rSidical Officer You are not required to comple tis question you are a Judicil officer or you are: filng asa judical oficer sppoinice. > D0 not report gis you have previously reported on the Expense Report for Exempted Persons.” > Legislators ae not required to report scholarships paid by a nonpartisan legislative organization of which th legislator or the General Assembly 1s 8 member, participa, o afflate. Date of Name and Address of Donor(s) Scholarship 16. Have you been appointed or considered for 3ppaNME to 8 covered board by the Governor or another Councl of State member? Council of State members are: > Governor > Lt. Govemor > Secretary of State > State Auditor > State Treasurer > Superintendent of Public Instruction > tomy General > Commissioner of Agriculture» Commissioner of Labor > Commisioper of Insurance Oves 1 “Yes, list all contrbutions you made in 2018 with a cumulative total of more than $1,000 t the Council of Stata member who appointed you. Bo not include contributions from immediate family members. > Contributions are defined broadly In N.C.GS, § 163A-1411(13) and ncude “any advance, conveyance, depos, stiution, transfer of funds, loan, payment, Gi, pledge or Subscription of money o anytning of value Whatsoever.” TT Cones WN contrbution(s) with 8 cumulative tal of more than $1,000 The SEL and any attachments, excluding the Confidential Form, are public records. Page sor so Te Tr SA po Te a the hed of 3 prio sate dpariment (3. cabinet secraary) appaned by he ahh . amemberef any of the folowing boards: ac Commssn + Coastal Resources Commission rho + State Board of Education Oves No Se bod of Becton ~ Onision of Employment Securty 3 No process to Envronmaralaragemers Camisson Question 18. Indust Commission ~ aman Resa Commision Rte Reem Comms + rt wermoraton © IRC aaardof Govemors ~ nites Common © Vite Resources Commission oT, wars you sponte or are yw ba eradred or spa ot Eves IN Seon oy Come of av mame’ Bre DY ueston 18. © 50, you must nate whether during 018 you eng99e3 many of he allowing ie Teak oor oh Bea of Comoro cap somes of a Conn of See meron whe spare go 1 Callcted contributions fom mull contributors, ak possession of such ime conmootons pa ao Sve ro eoeen onion to he inaasa r commeet 1. Hosted fundraise a your residence or place of business? [Ove Ome | W- Volatesed for campaigned seit, Including phone barks, ever re campaign of scone 5 ave vou ever ben convicted of any for wh you have ot recaved others () perder; or 1 on order of Fa Oves No [ ofews | ower conviction | Cony of Conviction | state of Gomaiion 5 eyo are of a oe formation hat yu Dleve may St the Es Commision no ou crn vo cmphance we Se Govan Sens SEP The SEE and any attachments, excluding the Confidential Form, are public records. Pagesorso The formation provided in tis Samet of xonomic Interest and any aachments ae re, compete, and crate ne em of my powidge ond Sle have not ransered, and wil nt transfer, any asst, interest, o propery for the purpose of concesing ft fom Gncionre whe remiing an suai meee. 1 understand that my Statement of Economic Interest and any attachments except for the Confidential Form regarding Unemancpates Coven se pose rca, have read and understand the follwing states: NC.G.5. § 1634-191. Concealingor fang to disclose material information A fing person who knowingly cones o knowingly fal to discos Information tht i recurs to be discosed on Satamant of eno eres shall oe ly of 5 Coc SG and Sp Spy ven nie 05, Semis. NCGS. 5 1630192. Panay for ls formation A fing person who provides fase formation an statement of economic rest knowing tht the Iormaton 5 (se 1 Guy of 8 las felony and Sha be Sbjct 15 nc acon andes re: ESA415. Laff th 1 have reviewed my most recenty fled 2018 Statement of Economic Itaest and tha a of December 21, 2018, my responses contin t be rue, COC, nd comets ie best of my knowiedge ad sere Xaffim under penalty of perjury thatthe foregoing is trus and corect. 311-2011 mature Bate Borda A. Seaub- Printed va Submit signed, original documents ony, Do not fox or e-mail his form. The SEL and any attachmants, axcluding the Confidential Form, are public records. Page 100110

Rn NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY ‘RY; ELECTIONS AND ETHICS ENFORCEMENT Date Received: RY 7 2018 STATEMENT OF ECONOMIC INTEREST 08 JN -5 PH 2 09 919-814-3600 wo nesbe gov/ENs/SEL | i THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL cnneg J! "YOUR SEI FILING OBLIGATION [eemriete tes mm mre wee for omens or A [Site of Nodh (niolina, [District faut Judge. NATURE OR TPE OF BUSINESS STATE GOVERNMENT 08 (Spec Agency ond Fosion) | GOARDICOMMISSION (Us complete rama ofa tate wh yon Sorin o a pio corstred) Adumnistadive Oca of the Cams (onprnorts Crime (umsission SUOICIAL OFICeR (spec Ofc) LEGISLATOR (pect House or San) [DigkrcF Court Judge n._Do other immedite family members reside in your household? Wes Oto When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also. includes members of your extended family (your and your spouse’s children, grandchildren, parents, grandparents, and oe spaces of eo of those arson) who 146s in your Rousohold othe mame of ai dts 373 rmancipated minors 7 your Household. A minor 2 chid under 18 years of. Pr ad Wl R20 eANCtDA fe, MINORS. estes J I EE _ The SEX and any atachments, sxcluding the Confidential Form, are public records. Pagerorio 5. Lit ONLY the Inflate of ll mermanpated miners in your household below. A mina 5 chid under 18 years od. Note: You must list the full name of each minor child on the Confidential Form available at the nd of this document. InmaLs For empLovER Sos Tine NATURE OF UNEMANEIPATED Uses inoRs ] Poh | daudnte Shuden aden td a 0 PROPERTY INTERESTS © of RSE A1_2012, 4 you, your spouse, of members of your immedi fom ave an ownersip terest n North Crolna rea state (ich you residence) wih a marke value of £16,000 or mare? les CINo [owner of Rest Estate| 56 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? ves fo meal Estate, Location | 1 Personal Propersy, Sy City & County Decrive Say me dri 18.2 F01Z, Yo your spouse, or members of your cea family sel 0 or by fam the Site ot North Carokis persaris property with a market vlue of 10,000 or more? DO ves who Name of purchaser Name of Seller Type of Property The SEE and any attachments, excluding the Confidential Form, are public records. Pagezor10 FINANCIAL INTERESTS 3. AS of December 31, 2017, dd you, your spouse, or members of your immediate family own any of the folowing financil Interests valued at $10,000 or more? LIST EACH COMPANY INDIVIDUALLY, A. Stack in a pully owned company? [ives [Ao +50 at list ownership Interests In & widely held investment fund (nduding mutual funds, regulated invesament compares, or pension or deferred compensation plans) If: (1) the Fund Is publicly traded or ts assets are widely diversified; and (i) neither you nor an immediate family member are able to control the assets held in the mutual fund, investment company, or pension or deferred compensation pian. —— 6. Stock Qations in» company or business? Clves whe Owner of Stock Option Full Name of Company (Do not use a ticker symbol) . Ioteests In 2 con-aublcly owned company or business enty (including Interest in sole propretorshios, partnerships, limited partnerships, Joie ventures, imiced habiity companies, imited liabilty partnerships, and Closely held corporations)? aT — [ owwormwes | Name of Company or Business Entity C3). For ach non-publcly owned company or business entity (the “primary company”) identified in question 3.C "above, please lst the names of any other companies or business entibes In which the primary company ‘owns securities or equity Interests valued a 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 The SET and any attachments, excluding the Confidential Form, are public records. Pages of 10 C2. you know th ary company or uses entity sted 1 3.C or 3.C(1) above has amy mater business Clings or mains comocs wi he Sar of Norih ral, or 5 reted by che Stat, provide a bet Gescrigion of ha busines actu Name of Company or Businass Entity Gescription of Business Acivity with the State [Rone or ot Known — 4 As of Dagember 31, 2017, were you, your spouse, or members of your immediate family the beneficiaris of a vested ut wn Sve of $10,008 or move tht was ese, samtaned, or conraned By your Do not ls assets hekd n bin trusts. See 2012 SEL Helofu Tis fo the deftion of "ested Tru” and "Bind Tusk” Ove who Name and Address of Trusts Description of the Trust Vour Relationship tothe Trust 5 As of Gicamber 312017, 00 you, your spouse, of members of your Eada family have lables of $10,000 or ore, Sxcaig a SAGs on youl mary persona es enca? Example Include cred card debts Ato loans, Studer Toone, Ghosona oan and ra fay Geb. A [=] Name of Debtor (You, Spouse, immediate Family | Type of Creditor (Commercial Bank, Credit Union, " Varmber) fndiduat, ec) [Nogth (ple. Stak, Buphyer Cradiidnion edit Union PRT Pond _ = Lis each satis of came (nk specific amounts) of ate a 35.00 recomed by You, Your so0u, o members of Vout Immdite fom dua 2007 Ince <Hary, wages, STKEIocH Governmans retirement, professions! fee, Hor a. denis emt come, peSness tore, 3nd othe Tes of ICO 16rd 13 8 epOrES on You: Stace and dara a reams Do 29k include income received from the following sources: > Capita gains + Federal government retirement > wiltary ratirement » Social security ncome/ SSDI Recilantof Income Narme of Source Type of Type of tncome Lo Bainess/tndustey | 1) had no reportable income over $5,000 in 2017. > Bex acled-lAot. - Steeot NC. 0 D SH ees url] Gusen Cruddhited ene Kenta] R PY 8 [Bewertt J Sealed Soung WWklsoh ented [ Reutal Rips Serta oT W oars Feta ol Hig 10: Scorter | —hummy, ua > Reyhe The SEX and any attachments, excluding the Confidential Form, ae public records. Page of 10 PROFESSIONAL AND CIVIC RELATIONSHIPS (a1, Buioa 017, were you, your Spouse or members of your {Tumedlata family 8 recor, officer, governing board amber employed, independent contractor, or registered Ioboyst of 3 NoNproft corporation o arGanizaton operating in The State of Non Zaria pmo for riotous, chantabe, Sense, rary, oSHe heath and safety or SducatOnal purposes? ves (ho 1rNo," process to question. 755 not st State boards or aie, or éniies created by a polical subdven of he state, 00 0ot Ist organizations of which you are a mere member. | Do not st organizations of which you are mere member. Wis/ Hr position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization 700). 1 he nonprofit corporations o organizations sted shove do business wih the State of North Carolina o receive Sate une, please provid a bref Gescpuon of th nature of hat business, if Known or with which due dilgence could reasonably be known. ‘Name of Nonprofit Corporation or Organization | Describe Stats Business or State Funding _ None or Not Known Bung 2017, were you, your Spouse, OF Members of Your [mMESIALE family 3 vector, ofcer, o governing bosrd romero any society, Organon, o 404ocacy Group wih an ETEE In makers ver which your SG8nCy of ard may Rove urdicnon? [ves (#6 CLegisatorudcal Officer - You are not required to complete this question f you are lng because Vou are 3 egator or 3 Juciil fice of You are ng 2 an appote to hose oes. 00 not st organizations of which you ae only a member (not serving n a leadership role) ‘Name of Society, Organization Leadership position or Advocacy Group (Dirsctor, Officer, Board Member) The SE and any attachmants, excluding the Confidential Form, are public records. Pages oro 902). Uist the name esc company o business wih wih you were assocted wher you ar a reer of your mada {ami was an emioyee, decor, ofcer, garner, rope, of meme o momases eof Beem 1a San Namo of Person | elatonship to Filer Name of Company Rote of Person Zio Busines Assoctons ore — re — {—— $09.1 you know has any company o busines ety iced in 5(0) above nd avy eral business Geng or sings Conracs wih th State of North Cares of was regulated by 4h es oo ack oir 9 0 if description of that business deci. Nam of Company or Business Entity ‘Description of Business Acuity with the State ot sppicae (to ene ed on 393) [ry Sep p——— Dives (INo ifoudicial Oficer/State Attorney 16 Yes" check each category of egal representation n which you o She law frm with which you ae offlaced nas eomed egal fo of more han $10,000 nos 20s. Dramatis Cinamiaty Corporate camel CIoecedents estes Citnvionmenta insurance Qavor Cltoes Governmen vest propery Secures Oox Tort gar (incoding CJubites Regulation [ther category nt ste patie 11. ung 201Zwere vou 3 ansed professional (her han an sory) o 4d you provide ensuing sermees indiially or 35 3 member of professional sssoceton or WER yo harper espe Er ond Ove fhe [woos | Nature of Services Rendered Th SEX and any atachments, excluding the Gonfdenial Form, are public records. Pagesorio 13. Ave you o your empayer, your spouse or members of your immediate family, or their employer curl: + Licensed by the State board or employing ant wth which you ae or wil be associated or + Regulated by the State board or employing entity with which you are or will be associated or Have business relations with the State board or employing ant with which you are or wil be associated? [Ives [No [egisiator/Judicial Officer - You are not required to complete this question If you are ling because a aaron or ssi) Shea ual officer (> defined in the SE1 Hell Tgs) or You Ire ing 25 on appatncs to those afices. ‘Name of Person T Name of Employer Type of Relationship | (if applicable) | (Licensing, Regulatory, Business) J NE: EE ————— 3 Ave you your spouse or member of your immediatly currenty registered as 3190 or lobby PrnGpal, or ‘were you registered as such within the 12 months preceding vour filing of this form? ves fe Name of Lobbyist Lobbyists Principal Date of Registration Regiswation | "Expiration OTHER DISCLOSURES 14. During any calendar quarir In Z01Z (but ory the Ems period ater you were appointed, employed or fled or were Sernated as» canaidae), da you + receive any “gift(s)" exceeding $200 per quarter from a person or group of persans acting together, and. hen beth you a thos person(s) were outside Nar Caroin at the ime you accepted the G(s), aud © th oft) were given under circumstances that would lead a reasonable person to conc tha they were given for lobbying? 0 nt report gis Given oy members of your extended aly. + 0g nt report gifts that have previously been reported by You to the Department of the Secretary of Sate on the £2, pense Report for Exempted parsons.” | ‘Nome and Address of Donor(s) | Describe Item Received | Estimated Market Value The SEX and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2017 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) te et pe 0 1f “Ves”, list all contributions you (NOT immediate family members) made during 2017 with a cumulative whatsoever,” nel CT ES EC TR A rans orio 17. Are you an appointee o prospective appointee to 2 he head of a privapal sate department (&.9. cabinet secretary) appointed by the Governor; or 5. a North Caraina Supreme Court Justice, Court of Appeals, Superior o District Court ude; o c. a member of any of the following boards: + ABC Commission © Coastal Resources Commission ~ + State Soard of Education ves [fo + State Board of Elections Owision of Employment Security Ir "No proceed to © Environmental Management Commission Question 18. © industrial Commission © Human Resources Commission * Rules Review Commission © Board of Transpartation Yo Colernoe's « UNC Board of Governors. ed ; noe + Utilities Commission Crime Commission. + Widife Resources Commission 4150, were you appanted or are you being considered for appointment to that. | (Jes (Alo inch of tae member? Counc of State members are sted |r “No,” proceed to TP avesion 16. Question 18. Tse, vou must indicate whether during 2017 you (not immedate family re angaged in any of the folowing activities wih respect t or on behalf of he Conca of campaign committee of the Council of State member who pened you to your public postion Ove CNe \ Collected contributions from multiple contributors, took possession of such lite contributions, and transferred o aelvered those collected ntinons to the candidate or committee? Contributions are defined in Question 16 ested a fonaratser at your residence or place of business? Dives CiNo i olunteare for campaign related acviies, whic Include, but are nt imited ee, event assistance, Malings, canvassing, surveying, or any | C1¥es CINo hr achvty tha advances the campaign of a candidate? To ave you over cn concied of a felany for which you have no recelved ether: (1) 3 pardon of innocence; or (1) an order of expungement regarding that conviction” ove fe offense “Date of Conviction | _ County of Conviction | _ State of Conviction Toe you aware of amy other information that you believe may assist the Skate Ethics Commission in adising You onceroing your compliance wih the State Government Ethics Act? ClYes (6 1fyes, please provide such information below. the SEL and any attachments, excluding the Confidential Form, are public records. Pages of 10 aff th cmon provided nts Sitcment of Fearon ert a ny ache hc ae, plo, dss 5 et of my Soom ad Tat orf i os os anor, and ill nos ne any st, cst, o rent he purpose of concn om Gone whe eg on cba ms derstand my Stment of Economic ners ad any tachment spleens her (vi he xcption of he Contam Formentera we es Vacknovids tha en reds esd NC GS. 35A.26 reading concn a in discos mri tomar A NCC. AT vgn ov os 130026, onal fing o discos mati formation Ailing rs who knowingly conceal knowingly fi dicloss information ts eurd tb dios on sin of canons Hs Are Sl be Joly of Clo | irons ds dan soni 08 ham §196027. Ply fo Fe frtion A ig perm who provides ls formaion on semen of comic rest udder is Arle ovina ie yo Clos Foy and hh ec ns snk rie Ra &75 2M 5.40908 Bevse Dayle Le Submit STONED, ORIGINAL documants env. 00 not fa ox snl sis form, The 5 and any atachments, exciting th Confdania Form, are public ec. vege s00r 10

4%. NORTH CAROLINA STATE BOARD OF FOR COMPLIANCE UNIT USE ONLY SX". ELECTIONS AND ETHICS ENFORCEMENT Oats Recenes 7 2018 STATEMENT OF ECONOMIC INTEREST 919-814-3600 ‘www.ncsbe.gov/Ethics/SEI p HAR =2 PHI: LL PAC rec to completion THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL | L2Sames J 8Houe YOUR SEI FILING OBLIGATION feomplee rs Supp. Sot te Fo Supp. Raced Owe 2 cnr mansvudod or J. [ Pwey [A [oat] (Jakes Nth (olive [Dighviet Court Judge | boards on which you are serving or are being considered Pane ofretel JUDICIAL OFFICER (Speciy Office) LEGISLATOR (Spec House or Senate) (Dishtk Colluge 1 A. Do other immediate family members reside in your household? {eres Cine When used throughout this form, th term Immediate family Includes your spouse (unless legally separated). It 50 includes members of your extended family (Your and Your spouses children, orandchidre, parents, grandparents, and RE ist the full ame of ail adults and emancipated minors in your household. A minor is a chid under 18 years od | Minors are emancipated by marriage, enlistment in the US miltary, or court order for emancipation pnchavio non’ |” | BUSINESS Moy 0. Stated | Mfr [Relvied — [Rebied | Rekied | The SET and any attachments, excluding the Confidential Form, are pubic records. Page 1 0f 10 Note: You must list the full name of each minor child on the Confidential Form available at the ‘end of this document. Ja Ry I EE EE EE 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 Carolina real estate (including your residence) with a market value of GXfes [No % Ownership Interest Location by County | I EE B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of ve fhe Seren ie, ion | 2. At any time during 2016 or 2017, did you, your spouse, or members of your immediate family sell to or buy from the | Nemeofpurchaser | Nameofsemer | Type of Property ne x sn a tachment exclu he Conn Frm, rs public corde, pe zar10 < g H 3 [=I PA HH 2158 H FRESE tA aL aL g|2 g 22 [2 |E ERE] £ £1212 (2 g |x 22 2 12 12 [2 z [cg EF 2 ENERERE £ 5 g : = g £ " i £ |g |& £8 [8 S |< |< |< |< |< 4 FEE EEE H «& = = H] a g £ | H 5 H S g = H £ H s El = H 2 H H 2 ° H £ |e EE ] a 31505 )E 2 ERERERERE zz 52 Ss EEIEIE 3 2 | 22 [FinanciaL interests 13. As of December 31. 2017, did you, your spouse, or members of your immediate. family own any of the following financial | interest valued a $10,000 or mor? LIST EAGH COMPANY THDTVIGUALLY. | Stak ma hen owned compe Ove ho [750 out ist owners eres Tn 3 widely hid investment und (nclading mama nds, equated investment Companies, or penlon or Gefered compensation pans) i. (1) he und PDI ded or 1 assets ae wisely verse and (1 noRher you no a Tvmedats {aly amber ars abi t Control th assets eld 1 he Mal fd, investment compahy. or perion or defeeas tamparadlon pa Full Name of Company (Do not use a ticker symbol) 8. Stock Options in a company or business? Ove off Owner of Stock Optien Full Name of Company (Do not use ticker symbar) | 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 rations)? ves he 10°No, proceed to question 4. rr € (2). For each non-publicly owned company or business entity (the “primary company“) identified in question S12 "above, east Itt homes of any athe Compares of Sis xis 1 which tne primary company owns Secures or ety terest valued at ovr $10,000, 1 known: Non-Publicly Owned Company or Business Entity | _ Other Companies In which the Primary Campany (he primary Compam) Owns Security or Equity interests The SEI and any attachments, excluding the Confidential Form, are public records. Page 3or10 Ca ym ow ty com orbs ary Tie Cr 3.) shove hs ary tel bois Ging eines coma wh Sore of Noh Corl 6 SH he Sie, owes an sft us ety Name of Company or Busines Entity Description of Business Aci with ie Sate rr | 4. As of December 31, 2017, were you, your spouse, or members of your immediate family the beneficiaries of a vested ut 3 oto E8000 0 ov Sh ws ee, Sams cro pou Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” ves fhe Name and Address af Trosies |Description of he Trust| Your Rlatanahi othe rut 5 Ae of Decarher 2012 0 you yor spouts, or mars of your mma rly have abe 7510.00 o ore A Aa oo hoy srt ene BP A rd Ser oe se oes Ono Name of Debtor Yau, Spoues, immediate Fay | Type of Cradior Camera Sans, Cred Union, (et) fobs) North Code, SHEL Goloeess Colt) Cedi loon | BB<T 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. Include salary, wages, state/local government retirement, professional fees, oor ars: end. ol cme: Busnes nore, a Se so ms ied be enor on vot Ta ved 00 at includ Income recived fom the following source: » Cota gene > Federal government etrement * itary resrement > Soca sucuriyincome/ S501 Recent of Income Trpeot Tope ot trcome less tocusry (1 had no reportable income over $5,000 in 2017. Bovey ScocketeTsh[C wen Codchied | Reatol | Real | The SE anc any stachments, exciting th Confidential Form, ar public records. Page sorio PROFESSIONAL AND CIVIC RELATIONSHIPS 72) Duting 2012. were you, your spouse or members of your immediate family a dredor, ofr, governing bord Dn oD Fr os board he State of Noin Caroves pimaray Tor eles charts, epee, Mesa Du: Seok one ator oscar | rose? | |» Do not list State boards or entities, or entities created by a political subdivision of the State. | > Do not list organizations of which you are a mere member. eT Wiser Postion Name of Nonprofit | Nature of Business or Corporation or Organization | Purpose of Orgamaton 70), Ithe nonproft corporations a crganzatons Veted ove do Buses withthe State of orth Carl ores De min. yogus Teasona be now, Name of Nonprofit Corporation or Organization Describe Stat Business o State Funding hone or tot Know 8. During 2017, were you, your spouse, or members of your immediate family a director, officer, or governing board ER I TR rt FE] To eamenens [Ives (fo. [Legislator Judicial Officer - You are not required to complete this question f you ar filng because | a ee rere, D0 no st crgaizatons of which you are any a member (ra serving i a leadership rol). Name of Society, Organization prom fob (Director, Ofeer, board Member) The SEE and any attachments, excluding the Confidential Form, are public records. Pages or10 [5(a). List the name of each company or business with which you were associated where you or member of your Immediate | family was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2017. ams rverson | wasionp eri | ome rcampany | roearoamen | Lr rr I EE EE I I EE I EE EE business contracts with the State of North Carolina or was regulated by the State as of December 31, 2017, provide a 1 — EE EE ve we om ove, coco csr otro 1h ur ih hh our sts ard legal fees of more than $10,000 during 2017. SE Creve Conare orm [m} Tort sigation (including (Utilities Regulation [7] Other category not listed. oy 11. During 2017,were you a licensed professional (other than an attomey) 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? Oves ho - EE ve Sc 20 ny chr acing Content Frm ae pt recat. — 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 wil be associated or + Regulated by the State board or employing entity with which you are or wil be associated or . tea uss lito ve State board or employing entity with which you are or will be associated? [Yes [No Legisiator/udicial Offcer - You are not required to complete this question if you are filing because you are a legislator or a judicial officer (“judicial officer” is defined in the SEI Helpful Tips) or you are fing as an appointee to those offices. I Name of Person Name of Employer Type of Relationship (if applicable) (Licensing, Regulatory, Business) [ I 13. Are you, your spouse or a member of your immediate family currently registered as a lobbyist or lobbyist principal, or were you registeped as such within the 12 months preceding vour fin of this form? Oves a | Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration OTHER DISCLOSURES 14. During any calendar quarter in 201 (but only the time period after you were appointed, employed or fled or were nominated as a candidate), did you + receive any "gi(s)" exceeding $200 per quarter fom 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 gif(s), and « the giR(s) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying? Yes tn 50 not report gs given by members of your extended family. D0 not report gifs that have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted Persons.” The SET and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 15. During 2017 (but only the time period ater you were appointed, employed, or fled or were nominated as a candidate) did you + accept a “scholarship” exceeding $200 from a person or group of persons acting together and + those person(s) were outside North Carolina and + the scholarship was related to your public position? A “scholarship” is a grant-in-aid, either direct or indirect, to attend a conference, meeting, or similar event, including tuition, travel, lodging, meals, and other similar expen [Ives Co ms Officer - You are not required to complete this question if you are a judicial officer or you are fing as a judicial officer appointee. | |» Do not report gits that have previously been reported by you to the Department ofthe Secretary of State on the | “Expense Report for Exempted Persons.” |» Legisiators are not required to report scholarships paid by a nonpartisan fegisiatve organization of which the legislator or the General Assembly is a member or participant or an affiate of that organization. Date of ‘Name and Address of Donor(s) Describe Event Scholarship 16. Were you appointed or are you being considered for an appointment to a covered board by the Governor or another Counc of State member? Council of State members are: > 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 ves he 1 “Yes”, list all contributions you (NOT immediate family members) made during 2017 with a cumulative total of more than $1,000 to the Governor or other Councl 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, depos, distribution, transfer of funds, 10an, payment, gift, pledge or subscription of money or anything of value whatsoever.” ET EC TR [Ro contrioution(s) with a cumulative total of more than $1,000 The SET and any attachments, excluding the Confidential Form, are public records. Pages of 10 17. Ave you an appointee or prospective appoites to: = the head of principal tate department (e.g. cabinet secretary) appomted by the Governor or 5.2 North Carolina Supreme Court Justice, Court of Appeal, Superior or District Court Judge; or . 2 member of any ofthe follwing boards: + ABC Commission * Coastal Resources Commission , + State Board of Education ves lo © State Board of Flectons Divison of Employment Security I “No” proceed to + Environmental anagement Commission Question 18. * Industrial Commission |< Human Resources Commission |< Rules Review Commision | Boat of Transportation © UNC Board of Governors * Utities Commission © Wide Resources Commission 1 so, were you appointed o are you being considered for appoint to that | C1ves [IN DUBE postion 5 Counc of State memo? Counc of rate MOmBErs a 620 | 1 one proceed to a quesion 16. is Ifo, you must indicate whether during 2017 you (not immediate fay member) engaged in any of the folowing achtics with respec t o on behalf of the candidate ar campagh commitee of he Counc of State member who appointed you to your publ postion Clves [No 1. Collcted contributions rom mutiple contributors, took possesion of such mile contributions, and transfered o delvered those calecied Contributions to the candidate or comes? Contringions are defined in Question 16 [oes ore yor romdenc or poe fbn? [Ove ov | I i. Volunteered for campaign-related activities, which include, but are not limited | <0, Bond banks, event assistance, malings, canvassing, surveying, or any | (Ives CINo Other acy th advances the campaigh of conn 16. Hove you eve been convicted of a felony for which you have not received ahr: (1 a pardon of inacence; or (1) an order of expngement regarding that comickion” Ove ho | omeme T oaeorconviction | County of Conviction | state of Conviction 19: Are yo aware ofan tne fort hat you elev ay 3 he Sat Epics Commision naviing you | Concerning your comalance wih the Sate Government Eins AGS ives fo ifyes, please provid such information below. | The SEI and any attachments, excluding the Confidential Form, are public records. Pages ori AFFIRMATION 1 afi that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. also certify that | have not transferred, and will not transfer, any ass, intrest, or property for the purpose of concealing it from disclosure while retaining an equitable interest. 1 understand that my Statement of Economic Interest and any attachments or supplements thercto (wih the exception of the Confidential Form regarding Unemancipated Children) are public record. Tacknowledge that 1 have read and understand N.C.G.S. 138A-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26, Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed ‘on a statement of cconomic interest under this Aticle shall be guilty of a Class | misdemeanor and shall be subject to disciplinary action under G.S. 138A. § 1384-27. Penaly for false information. A filing person wh provides false information on a statement of economic interest as required under this Aticle knowing that the information s false s guilty of a Class H felony and shall be subject to disciplinary action under GS. 138A. | | 4-46 0B Signature Date Yim Printed Napke’ ‘Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. | The SEX and any attachments, excluding the Confidential Form, are public records. Page 10 0f 10

M pe 2017 STATEMENT OF ECONOMIC INTEREST | Date Received: . 919-814-3600 wi ethicscommission nc. gov THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL bene for competion YOUR SEI FILING OBLIGATION pe a bt = Some wy Sua. Recon Ome ___ | tere in awavosn 77/ wy A. | usa wane ens, mooie, Las) . - prefix | Frsthame | middie Name Last ame Suttx EN TT CuRReNT EMPLOYER son Tine [State of Noh Pawel, Distritk (put Judge [arue o Tyee or susiness i} . REASON FOR FILING [COMPLETE AL Ton Apt) ee [Fare coven 10 spec son | somo comsston ws camo nme of or tte = boards on which you Are serving or are being conmered Adwfatie Offre of Tha Lo lows 0 | IICIAL OFFICER (spect office) | eiSUATOR Specty House or Senate) | Distiet (od Judge | A. /Do other immediate family members reside in your household? | ves Ono | When uscd throught tis form, the term Immediate family includes your spouse (unless legally separated). I iso | includes members of your extended family (your and your spouse’s children, grandchildren, parents, grandparents, and | siblings, and the spouses of each of these persons) who reside in your household. Minors are emancipated by mariage, snitent 1 he U3 milano court 6a or enone ion FULL NAME OF ADULTS & | RELATIONSHIP | EMPLOYER 308 Timi NATURE OF | EMANCIPATED MINORS | = | I - | __ BUSINESS Nog W. Seodet] Tether In Rebied | Rebied | Fehirec] [Ras kA | S— I EE SE EE mm FS SE — — ES I The SEI and any attachments, excluding the Confidential Form, are public records. Page 101 10 |" Note: You must list the full name of each minor child on the Confidential Form available at the |__end of this document. | INITIALS FOR | RELATIONSHIP EMPLOYER JOB TITLE NATURE OF UNEMANCIPATED | BUSINESS (tamons | Sa Psi daughter | student | shuded- | stud — — | PROPERTY INTERESTS | 1. As of December 31, 2016, did you, your spouse, or members of your immediate family: | 4. Hove an onnershp interest n North Cron rea estate (including your residence) with a market volo of $10,000 or mores | ge ome Owner of test stots 5 unas inert | taco oy iy Location by County Ser. Mache | | _—m SE A I”. Lease or rent real estate or personal praperty t.or rom the State of Narn Corals with 2 marker vate of | $1000 or mores | ove mh | Name of Lessor Name of Lessee | 1f Real Estate Location | If Personal Property, (Renter) by City 8 County Describe Fete) | ovawacouny "| "mene B— + — —_— 12. at any time auning 2015 or 2015, dic you, your spouse, or members of your mediate family sell to or buy from the | State of North Carolina personal property with a market value of $10,000 or more? | ove fe Name of Purchaser Name of Seller Type of property — pp The SEL and any attachments, excluding the Confidential Form, are pubic records. Page 201 10 rar — I CREE sl = Tid iirifE:gogg z = = 5 2 2 =z | & 2 3 2 23 PE A AAT AREA fEEEEL BR EEE : EER 2 zz zzz zz 2 [2 AR RAR og [|| | 7 PE I I a ee ge g 8 g 8 8 Z g | 2 i | H |] | | z I] | § CE 5 | | El | g 8 z = al = FEE EEE EEE EE: OE z= §| 8 §/ § = 58 E/ 5 8 3% § gg 2 | HERE $8 § | HEIR | ££ 3 £ &| § % £ § 2 EEE | | 3 oo o © oo ¢ © oo oo eo of eo a £ 5 £ 8 5 £ 3 2 2 £ Z| 8 8 J e gE 8 £££ 8 ££ £ 2 2 2 EF FF OR ff % 3 3% 5% % 3 | le | 18 I g | | 2 re Lo i | HEE = zz 23 i EERE HE: 2 2 zz B |Z li EE EEE | I 18 Lg |g HE nas EEE EERE | 2 EB 2 2g HI El IF Lg 2 HEEEEN HineEne | £85 ¢%¢ {8% 3 BEE i. | | 8 || | 7 3 11 | bo 5 FANANUIAL IN IERES I> | 3. As of December 31, 2016, did you, your spouse, or 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 pyblicly owned company? ves Wo ~ _ [Bo nat Ist ownershiy nkerests ins wel ed investor nd {muding motoa onde eau meena Companies, or pension or deere Compenkation pane) i (1) the und 1 pave wanes 3 1 es oe || diversified; and (i) neither you nor an immediate fais ment sre Aes ‘control the assets held in the mutual fund, | invesiment company o ponder or defers compomeaton mn ro Owner of Interest 1 Full Name of Company (00 not use a ticker symbol) i i T — —— —— SE -_—mm — TT | © stock Options in a company or business? | Ow he er Owner o Stock Option Full Name of Company (Do not use a ticker symbol) EE A, — | —_— il C. Interests in a non-pyblicly owned company or business entity (including interests in sole proprietorships, | partnerships, limited partnerships, joint ventures, limited liability companies, limited abilty partnerships, and ose meld corporations? | ives ho- IF “No,” proceed to question 4. E Owner of Interest Name of Company or Business Entity —_— i —_— TT | C0) For each non-pubicly own company or business entity (ne “primary company’) Hemhied in avestion | S.C above, please Ist the names of any other companies of ess vos wm boo on ons Secures or equi interest voles at ver Sheia0, ee ne Non-public Oued Company or Business Entity | Other Companies in which the Primary Company | ne Primary Company) 1 Guans Security or Equty interests hone or Not Known ibibo EE Tf — | EE | The SEL and any attachments, excluding the Confidential Form, are public records. Page 3 or 10 eating or siness Contracts with the State of North Carolin, or 1s equited by th State, provide a bret | Goscnpuion of that business actviy. Name of Company or Business Entity Description of Business Activity with the State ions or tot Known (fforeorNotkomn a. As of December 31, 2016, were you, your spouse, or members of your immediate family the beneficiaries of a vested rust with a value OF $10,000 or more that was created, established, or controlled by you? | Do not list assets held in blind trusts. ‘See 2017 SEI Helpful Tips for the defingion of “Vested Trust” and “Blind Trust.” ves he Name 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, excluding he morgage on your primary personal residence? Examples include creditcard debts, auto loans, student | ars, personal loans and intra family debt ives Oo Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) Individual, etc.) TO eo Pati AALS Noth (ple, Sti Conployer> Cede aon] (eedit Union 6. List each sauce of income (not specific amounts) of mre: 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, Honorari, Interest, dividends, rental income, business income, and other types of income required to be reported on your State and federal tox returns. 00 ot include income received from the following sources: » Capital gains » Federal government retirement » Military retirement » Social security Income/SSDT Recipient of Income ‘Name of Source Type of Type of Income L Business, Industry - Tha no reportabie income over $5,000 in 2016 [Brody A Bradsll [poe - Slate 3 NC mplogmect Bevedu A 5 “ae Lo. WL Rawal Zental Bevedy A Seeded | Joway L. Wilsomy fc eu Reval A Steele |Cuoen Cratenfpeld | Henkel Teta] ; : RR SS S— SE The SEX and any attachments, excluding the Confidential Form, are public records. Page 40f 10 | PROFESSIONAL AND CIVIC RELATIONSHIPS 7(a). During 2016, were you, your spouse or members of your immediate family a director, officer, governing board vs fl rent > Do not list State boards or entities, or entities created by a political subdivision of the State. F—F——— ‘8. During 2015, were you, your spouse, or members of your immediate family a director, officer, or governing board [Yes Bro [J Legislator/Judicial Officer - You are not required to complete this question if you are filing because Do not list organizations of which you are only a member (not serving in a leadership role). | family was an employees, director, officer, partner, Broprietor, or member or manager a5 of December 31, 2016. | Name of person Relationship to Filer | Name of Company Role of person | ] | — 900). 1 you know that any company or business entity sted n 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, 2016, provide a brief Goscripton of that business acti i Name of Company or Business Entity | Description of Business Activity with the State [9 Not applicable (No entities listed on #9a) 10. Are you a practicing attorney? Ove [No (ffucicio Otfcer/State Attorney 16"Yes", check each category of legal representatan in which you or the las frm with which you are affliated has eared legal fees of mare than $10,000 during 2016. 0 Agmimstrative Amira corporate Cl crmmnal Decedent's Estates 0 Environmental [tnsurance Cltavor | (vocal Government eat Property Securities Qe Tort tigation (including Unites Regulation (0 0ther category not sted. negligence) | 11. During 2016, were you a licensed professional (other than an attorney) or did you provide consulting services. | idnidualy or a5 a member of 8 rotessional assacation or which you charged or were paid over $10,007 I re dn i Type of Business Nature of Services Rendered The SET and any attachments, excluding the Confidential Form, are public records. Page 6 of 10 | 44. ATE YOU OF YOUF €MPIOYEr, YOU SPOUSE OF MEMDErS Of YOUr IMMCAIALE Aimy, OF NEIr CMPIOYeT CurrEnGy: | + Licensed by the State board or employing entity with which you are or willbe associated or | + Regulated by the State board or employing entity with which you are or wil be associated or |» Have a business rlationship with the State board or employing entity sth which you are or wil be associated? [Ives [No (Wtegilator/luicial Office - You are not require to complete this question if you are fing because | Vou are a eqiiator o a yudical oficer (dal oficer i defined 1 the SE1 Helplal Tbs) or you are fing a3 an appointee to hose offices. Name of Person Name of Employer Type of Relationship (if applicable) | icensing, Regulatory, Business) SE — plicable) | (Licensing, Regula 13. Ara you, your spouse or @ member of your [mediate amity currently registered as 3 bbyit o 1obbyist principal, or | were you registered as such within the 12 month preceding your fing of th. form? i Ove Mio Name of Lobbyist i Lobbyist’s Principal | Dpateof Registration | Registration Expiration | | OTHER DISCLOSURES | OTHER DIS SE _ 14. During any calendar quarter in 2016 (but only the time period after you were appointed, employed or fled or were | nominated os a candidate) a you | receive any “ats” exceeing $20 per quarter rom a person or roup of persons acting together, and | + when both you and thase person(s) were outside North Caralina at the time you accepted the gift(s), and | + the ai(s) were given under circumstances that would ead a reasonable person to conclude that they were ven toring? | Ove fhe {500 not report gifts given by members of your extended family oo | | »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 V | Value | The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 Pr . . — + those persons) were outside North Carolina and i | + the scholarship was related to your pubic postion? A scholarship” is a prant-in-aid, either direct or indirect, | |" ko attend a conference, meeting, or similar event, including tuition, travel, lodging, meals, and other | | similar expenses. | es Co (fusical Officer - You are not rauired to complete this Question if you are a judicial afcer of you are | ing 26 8 judicial officer apport. | > Do not report git that have previausly ben reported by you to the Department of the Secretary of State onthe | |” Eupense Report for Exempted persons.” | | esis ant rere to reget scholars pdb a ong este araniznon of nn heer |” ar the General Ascemby 1s a member or particpant or an affiate of that organization. Dateof | Name and Address of Donor(s) Describe Event Estimated Market | Scholarship | Value i I EE I EE EE [T6. Were you appointed or are you bang considered for an appointment 1 a covered board by the Governor of another Council of State member? Council of State members are: > Governor » Lt. Governor » Secretary of State |» sure avtor » State Treasurer > Superintendent of Public Instruction | | Atomey General » Commissioner of Agrcuture > Commissioner of Labor |» Commissioner of insurance | ves dhe 1f “Yes”, list 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, | Capos, dbuton, transfer of nds, an, payment, Gf, pied o subscription of money or anything of value whatsoever.” vate Amount Contributed to } Ino contribution(s) with a cumulative total of more than $1,000 Hi The SEL and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 a. the head of 2 principal state department (2.3. cabinet secretory) appointed by the Governor; or |b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District | Court Judge; or | | ca member of any of the following boards: | + ABC Commission | © Coastal Resaurces Commission | + State Board of Education Oves fe | | © State Board of Eiections | + Division of Employment Security If “No,” proceed to + Enuronmental Management Commission auestion 18. + Industrial Commission | + Human Resources Commission i | + Rules Review: Commission | | + Board of Transportation + UNC Board of Governors + Utities Commission | Le WidifeResources Commission _ 6. If so, were you appointed of are you being considered for appointment to that | (J¥es (INo. | blero Cone oS member] Col of Se mares es | 1 to proceed to | Waveston 16. question 1. | [er 50, you must indicate whether during 2016 you (not immediate family 1 | members) 8ngaged in any ofthe lowing actives wth respect to on benal of | | the Candidate of compargh committee of the Counch of State member who | appointed you to your public position Cves CNo | i. Collected contributions from multiple contributors, took possession of uch | multige contributions, and transfered or delved those collected i Contributions to the candidate or committee? Contributions re defined in uestion 16 | | ii. Hosted a fundraiser at your residence or place of business? Cives (No | t iil. Volunteered for campaign-related activities, which include, but are not limited to, onone banks, event assistance, mailings, canvassing, surveying, or any | LI Yes CINo | other activity that advances the campaign of 2 candidate? 1 715. Have you ever been convicted of a felony for which you have not received either: () 2 pardon of innocence; or (i) an onder of expungerent regarding that conviction? | | ves fhe _ offense Date of Conviction | _ County of Conviction state of convicton__| T So oo — - 1 15. Are you aware of any other information that you believe may assist the State Exhics Commission in advising you | concerning your compliance vith the State Government Ethics Act? Lr ye oo — i i The SEX and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 ArrixmATioN | AT eer ————————eeer meee] | mismo ets omy Knowlodse and belt | from disclosure while retaining an cquiable interest. | § 1384-26 Concealing or filing to disclose material information. ! A filing person who knowingly conceals or knowingly fis to disclose information that is required o be disclosed | IA. Penal for fuse information. A filing person sho provides false information on a statement of economic interest a required under this Article | G5. 138A ial pf) | Lid) 35-2017 | Er ay — Bate | Buundn Au | Printed Name | - SIGNED, ORIGINAL documents only. Do not fax or email this form. 1 The SET and any attachments, excluding the Confidential Form, are public records. Page 10 of 10

455, NORTH CAROLINA STATE ETHICS COMMISSION | ror Eruics commission use ot & P 2016 STATEMENT OF ECONOMIC INTEREST | Date fecened: TT 19814-3600 wi ethicscommission.nc.gov pg Ji 27 Pi 118 THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL reckedlor camper YOUR SEI FILING OBLIGATION pr i SS — Supp. Sent Date By ‘Supp. Received Date ____ Entered in database on dl FILER'S NAME (FIRST, MIDDLE, LAST) 3 EO S— Me TBoecdy Hon Sade ‘CURRENT EMPLOYER 308 TITLE Sie, Noth Ciclo Dndick Cou Judge NATURE OR TYPE OF BUSINESS | Diskricr Court Judge REASON FOR FILING (SELECT ALL THAT APPLY) CJ STATE GOVERNMENT 108 (Please specify the agency | [J BOARD/COMMISSION (Please lst complete name of al for which you work or are being considered) State boards on which you are serving or are being - considered : UDICIAL OFFICER (Please speciy the office you hold) | [J LEGISLATOR (Please specify House or Senate) Digeiek Cou Fudge 'A._Do other Immediate Family members reside in your household? wes [No When used throughout this form, the term Immediate Family includes your spouse (unless legally separated). It also Incisdes members of your extended family (your and your spouse's children, grandchildren, parents, grandparents, and Ciblings, and the spores of each of those persons) who reside in your household. Lik the full nam of all adults and emancipated minors in your household. A minor i a child under 18 years oid. Minors are emancipated by marriage, enlistment in the US military or court order for emancipation. FULL NAME OF ADULTS & | RELATIONSHIP NATURE OF EMANCIPATED MINORS BUSINESS ard, U) Snclett [ther [Retied [ruined | Rebied elired The SET and any attachments, excluding the Confidential Form, are public records. Page 10f 10 Bs 1B. Ut ONLY the initials of all anemancipated minors In your houseiold below. A minor i a child under 18 years ra ee emancipated by mariage, enistment n the US milkary o court order for emancipation. Note: You must list the full name of each minor child on the Confidential Form available at the end of this document. INITIALS FOR RELATIONSHIP EMPLOYER JOB TITLE NATURE OF UNEMANCIPATED BUSINESS iNors ] PROPERTY INTERESTS 1. As of December 31, 2015, did you, your spouse, or members of your immediate family: . Have an ownership interest In Noth Carolin real estate (including your residence) with a market value of $10,000 or more? hes re Owner of Real Estate| % Ownership Interest | Location by City B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of $16,000 or more? Ove @o Name of Lessor Name of Lessee | If Real Estate, Location | If Personal Property, (Renter) by ity & County Describe. 2 A omy time during 2014 2015, did you, your use, o members of your immediate. family sll {0 o buy from the ‘State of North Carolina personal property with a market value of $10,000 or more? Oves ho Nome of Seller The SEI and any attachments, excluding the Confidential Form, are public records. Page 20f 10 Pie =F TF = CEE EERE 233932 23 PF > [2 > PB 8 I A ATA IA IAA 2 2 12 2 12 [8 |B 8 8] 8) 8] & ERE EEE EEE :E = |= 8 | | | = es gl ® 8 3 F EINES RR A A 8 pg g Ei 3 z BIEEEEERE zl 3 gg 8 9g E gz g 5 E =| H 2 2 3 Fg g | 3 EEE EE 255 E 5 § FE gl gg £| BE E| EE g gl | 2 HERE IEEE EEE § § § = § §| 3 g EEEEEEEEEEEEE f182495:5;22535¢4°¢8¢:¢ g &| §| 8 %| 8] | % % 8] 8] 5 3 g 2 BE g Bh 2 2 2 2 g 3 5 8 3 HEE al of a 8 a a8 7 7 = El 2 1 H 2 g 3 S 2 2 z =i = a E 3 H 5 g 2 H 3 3 El 3 £11 ¢ 8 g| 3 2 : 2 | g we 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 et $10,000 or more? A. Stock in a ppblicy owned company? Oves to RE »Do not list ownership interests in a widely held 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 versed; and (1) neither you no an immediate amy member are able to control the assets held in the muttal fund, investment company, or pension or deferred compensation pian Owner of Interest Full Name of Company (00 not use a ticker symbol) B. Stock Qptions in a company or business? aves clhe 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)? Yes @fio - IF "No,” proceed to question 4. C (4), For each non-public owned company or business tity (the “primary company) Identified in question 5.C above, please Ist the names of any other companies o business entities In which the primary company wins securkies o equity interests valued at over $10,000, 1 known. Non-Publicly Owned Company or Business Entity | _ Other Companies in which the Primary Company. (the primary Company) ‘Owns Security or Equity Interests per The SEI and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 Be 2). you know hat any company o busines ony ied Cor 3.CL1) above has any moverl business igo esos cota on Seve of rt Coralia, o reseed the Stes ene oct eon of tot users acy. Nome of Company or Business Entity Description of Business Activity with the State fons or Not Known | 4. As of December 31, 2015, were you, your spouse, or members of your immediate family the beneficiaries of a vested I rrr MAA A er AM Ay | Do not list assets held in blind trusts. See 2016 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust. ves fo Name and Adress of Truss Description of the Trust Your Relationship to the Trust 5 eof Bamba L215, 40 you. your spove, or members of your Tamla fry have abies of $10,000 of ‘more, excluding the mortgage on your primary personal residence? Examples include credit card debts, auto loans, student ond aero be. Efes Oto Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, frou [vit] [Beoodg Adalat | Cred Unio Revey 4 Scarlett Lown firm 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 2015. Include salary, wages, state/local government retirement, professional fees, Ho a iea come, pion neers 374 Wer ibe of meas eared 1 be repaned of voor Son ede ow ror, Do gat include income recsived from the following sources: + Capita gains + Federal government retirement + Miltary ratcomant + Socio security income/ SSD Recplent of Income Name of Source Tyme or Eeprrm— Business/Industry a no reporabie come aver $5,000 1 2015. | Sade | Soumy Wily Bevedy A Sader [Shade 3 NC The SEL and any attachments, excluding the Confidential Form, are public records. Page dof 10 3 PROFESSIONAL AND CIVIC RELATIONSHIPS 7(e). During 2015, were you, your spouse or members of your immediate family a director, officer, governing board member, employes, independent contractor, or registered lobbyist of a nonprofit corporation or organization operating in the State of North Carolina primarily for religious, charitable, scientific, literary, public health and safety, or educational | purposes? > Do not list State boards or entities, or entities created by a political subdivision of the State. » Do not ist organizations of which you are a mere member. His/Her Position Name of Nonprofit Nature of Business or Corporation or Organization | 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, please provide 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 [J None or Not Known §. During 2015, were you, your spouse, or 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? ‘you are a legislator or a judicial officer or you are filing as an appointee to those offices. »Do not list 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(b). If you know that any company or business entity listed in 9(a) above had any material business dealings or business contracts with the State of North Carolina or was regulated by the State as of December 31, 2015, provide a brief description of that business activity. 1 EY A —— legal fees of more than $10,000 during 2015. 0 Local Government [0 Real Property [0 Securities OTax [Tort litigation (including (0 Utilities Regulation [J Other category not listed. 11. During 2015, were you a licensed professional (other than an attorney) or did you provide consulting services res don ETT TN Rots of seis Rendered we TS ST OP TPR AIAN « Requlated by the State board or employing entity with which you are or will be associated or were you registered as such within the 12 months preceding your filing of this form? Oves No aves fhe 22 15. During 2015 (but only the time period after you were appointed, employed, or filed or were nominated as a candidate) did you * accept a “scholarship” exceeding $200 from a person or group of persons acting together and + those person(s) were outside North Carolina and + the scholarship was ralated to your publi postion? 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. Ces Ce ft fe You are nt reuret complte hs cuestion of vou ae dc afr oyu re fing as a judicial officer appointee. > D0 not report ifs that have previously been reported by you t the Department of the Secretary of State on the “Expense Report for Exempted persons.” > Legislators are not required to report scholarships pad by a nonpartisan legislative organization of which the legislator or the General Assembly 5.2 member or participant or an afte of that organization. Date of Name and Address of Donor(s) Describe Event Scholarship 16. Were you appointed or are you being considered for an 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 > Attomey General > Commissioner of Agriculture» Commissioner of Labor > Commissioner of Insurance. Oves de 1 “Yes, lst all contributions you (NOT immadiate family members) made during 2015 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, deposit, distribution, transfer of funds, loan, payment, gift, pledge or subscription of money or anything of value: whatsoever.” BE TS CI No contribution(s) with a cumulative total of more than $1,000 The SET and any attachments, excluding the Confidential Form, are public records. Page 8 of 10 —_— 17. fle 30,8 An Sntes ox pros dive SHPO OR V0 i S| 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 pe + State Board of Education OYes [@No + State Board of Elections + Division of Employment Security If “No proceed to + Environmental Management Commission question 18. + Industrial Commission + Human Resources Commission + Rules Review Commission + Board of Transportation + UNC Board of Governors + Utilities Commission « Widife Resources Commission d. 1f so, were you appointed or are you being considered for appointment to that Oives [No public position by a Council of State member? Council of State members are listed | gr No,” proceed to in question 16. question 18. e. If 50, you must indicate whether during 2015 you (not immediate family members) 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 to your public position: +. Collected contributions from multiple contributors, tock possession of such ‘multiple contributions, and transferred or delivered those collected contributions to the candidate or committee? Contributions are defined in question 16. ii. Hosted a fundraiser at your residence or place of business? DYes [No ii. Volunteered for campaign-related activities, which include, but are not limited to, phone banks, event assistance, mailings, canvassing, surveying, or any | (1 Yes [INo other activity that advances the campaign of a candidate? 18. Have you ever been convicted of a felony for which you have not received either: (1) a pardon of innocence; or (i) an order of expungement regarding that conviction? Qves tho offense Date of Conviction State of Conviction 19. Are you aware of any other information that you believe may assist the State Ethics Commission in advising you concerning your compliance with the State Government Ethics Act? Dives fo ives, ss prove such formation bon: ‘The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 AFFIRMATION Taffirm that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, and accurate to the best of my knowledge and belief. Lalso certify that I have not transferred, and will not transfer, any asset, interest, or ‘property for the purpose of concealing it from disclosure while retaining an equitable interest. 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. Lacknowledge that I have read and understand N.C.G.S. 138-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: § 138A-26. Concealing or failing to disclose material information. A filing person who knowingly conceals or knowingly fails to disclose information that is required to be disclosed on a statement of economic interest under this Aric shal be guilty of a Class | misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 1387.27. Penalty for false information. A filing person who provides false information on a statement of economic interest as required under this Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A-45. ElTagree Ani 1: 71-301 Signature Bate ow AS Printed Name Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. ‘The SEI and any attachments, excluding the Confidential Form, are public records. Page 100f 10 3

."“._ NORTH CAROLINA STATE ETHICS COMMISSION ak | MMISSION USE ONLY ©! .4/; 2015 STATEMENT OF ECONOMIC INTEREST FOR ETHICS CoN i 919-715-2071 www. ethicscommission.nc.gov ois WR 18 PH 2 11 FILER'S NAME (FIRST, MIDDLE, LAST) [ rrstteme | wedemame | tasthame [sum | Bevel CURRENT EMPLOYER 108 TITLE Noch Carolina, AD shriek Cound dq NATURE OR TYPE OF BUSINESS. 1dge — REASON FOR FILING (SELECT ALL THAT APPLY) STATE GOVERNMENT 10 (Please specify the agency for | [] BOARD/COMMISSION (Please lst complete name of ail “hich you work or are being considered) | State boards on which you are serving or are being |__ considered) Noth Cavdunge Dudicial Depaxkinent- [GIUDICIAL OFFICER (Please specify the office you hod) _| CJ LEGISLATOR (Please specify House or Senate) Dishviek Court Judge 0 ggher Immediate family members reside in your household? mies Ono When used throughout this form, the term Immediate family includes your spouse (unless legally separated). It also Includes members of vour extended family (your and your spouse's children, grandchildren, parents, grandparents, and Siblings, and the spouses of €ach of those persons) who reside in your household. ONLY LIST THE INITIALS OF UNEMANCIPATED CHILDREN, However, you MUST submit the chidren's full names on the ‘Confidential Form avaiable at the end of this document. Minors are emancipated by marriage, enlistment in the US miltery, or court action for emancipation. EMANCIPATED MINORS The SEX and any attachments, excluding the Confidential Form, are public records. Page 10f 10 "INITIALS FOR | RELATIONSHIP EMPLOYER NATURE OF UNEMARCIPATED BUSINESS “CHLoReN PROPERTY INTERESTS 1. As of December 31, 2014, did you, your spouse, or members of your immediate family: A. Have an ownership mares In North Carolin rel estate (inluing you residence) with a marke value of $10,000 on? es Oo |__ Owner of Real Estate | % Ownership Interest | Location by Cty | Location by County Bevecly Scarlett EEE. b | Brood Seaett | 00 | Dadam | Oe l Boul] Sealer \0o Dudan B. Lease or rent real estate or personal property to or from the State of North Carolina with a market value of $10,000 re? Ove he Name of Lessor If Real Estate, Location | If Personal Property, ov City & County Describe 2 A omy time during 200301 2012, dW you, your spouse, or member of your Imedate fami sll 1 of buy rom the a bern property wit a market value of $10,000 o mores Ove ho [ Nomeofpurchaser | Mameofseer | Type of Property The SEX and any attachments, excluding the Confidential Form, re pubic records. Page 20r 10 PROPERTY INTERESTS OWNER OF REAL ow Ei | Boe alow 0 Hilsherea dn Dang lan Seam os ET — [Mosi) Sear | ET PT eed cvlet 2] (£1 Diane. [Pes Salaf 55 | Duden A ary FinaNCIaL INTERESTS 3. As of December 31, 2014, did you, your spouse, or members of your immediate family own any of the following financial Tetra eae Stock in publicly owes company? Oves oho 05 cut st awnersip terest in a widely held investment fund (ching mutual funds, epited mvesTeTt ar en or Sn Speen To) gal muted Sut, plated vesimerk es a pets vo et oe Jar DUDA rade of ir are dey Ee am Sonam er mma ruven compeny oo voi sin Py peere— Oves fo 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 (including interests in sole proprietorships, a par rere et eb ing Ste Sole OBS, nd Ce rate pr [ves Ro - If *No, proceed to question 4. TT oma | meee sein Tha SEL and any attachments, excusing the Confidential Form, are public records: Page 30110 4. As of December 31, 2014, were you, your spouse, or members of your immediate family the beneficiaries of a vested Do not list assets held in blind trusts. ‘See 2015 SEI Helpful Tips for the definition of "Vested Trust” and "Blind Trust.” Name and Address of Trustes Vour Relationship to the Trust| S. As of December 31, 2014, did you, your spouse, or members of your immediate family have habilities of $10,000 or more, excluding the mortgage on your pnmary personal residence? Examples include credit card debts, auto loans, Wes DONo a Ea — 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 2014. Include salary, wages, state/local government retirement, professional fees, Sos er re Oo at ncude income received rom the allowing sources cata gains » recrat government retirement > Witary reiement > Socal security income/ S501 Recent of income Name of Source Type or Eo p— nets tngusiry Cities vo gare rege ser $500 mE [Hos of Sater (oti Lidllebon (lord Tera | Ped PROFESSIONAL AND CIVIC RELATIONSHIPS 7(2). Dunng 2014, were you, your spouse or members of your immediate family a director, officer, governing board pki Oves who - If “No”, proceed to question 8. Name ofFerson | Wia/Her postion | Nome of Nonprot | ature of susmans or Corporamon or npeniaton | purpene or amnion prose inal Name of Nonprofit Corporation ar organization Describe Sate Busines or Sate Fanny The 51 and any attachments, excluding he Confidential For, ars public records. Page sor10 8. During 2014, were you, your spouse, or members of your immediate family a director, officer, or governing board Oves Ono fCegistator uit Officer - You are not required to complete this question If you are filing because or Advocacy Group (Director, Officer, Board Member) ‘contracts with the State of North Carolina or was regulated by the State as of December 31, 2014, provide a brief OYes [No frusical Officer/State Attorney legal fees of more than $10,000 during 2014. [J Administrative 0 Admiralty [J Corporate OJ Criminal [J Decedent's Estates [J Environmental [J Insurance OLabor [J Local Government [Real Property [0 Securities OTax 1. During 2014, were you a licensed professional (other than an attorney) or did you provide consulting services individualy o 25 3 member of 2 professional association fr which you charges o were pars over 10. o0p Ove fo Type of Business Nature of Services Rendered 12. Are you or your employer, your spouse or members of your Immediate formly, or their employer currently: * Licensed by the State board or employing entity with which you are or wil be sociated or + Regulated by the State board or employing entity with which you are or will be associated or . i with the State board or employing entty with which you are o wil be associated? Dies CINo. (fkegisiator/iudical Officer - You are not required to complete this question if you ar fling because you are legislator or Judicial officer (ucicial officer 15 9efind In the SET Hapfol Tp8) or yas ane Ting 55 an appointee to those ofces. 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 preceding your filing of this form? ove che Name of Lobbyist Lobbyists Principal Date of Registration Registration Expiration OTHER DISCLOSURES 14. During any calendar quarter in 2014 (but only the time period after you were appointed, employed or fled or were nominated a3 a candidate), did You « receive any "Gif(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 9ift(s), and + the Rs) were given under circumstances that would lead a reasonable person to conclude that they were given for lobbying? Oves wf 0 mot report gifts given by members of your extended amy >Do not report git tht have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted persons.” The SEI and any attachments, excluding the Confidential Form, are public records. Page7of 10 15. During. 2014 (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 2 person or group of persons acting together and + those person(s) were outside North Carolina and « the scholarship was related to your public positon? A “scholarship” is a grant-In-aid to attend a conference, meeting, or similar event. Des Oe rman Officer - You are not required to complete this question If you are a judicial officer or you are. fling as a judicial officer appointee. > Do not report gifs that have previously been reported by you to the Department of the Secretary of State on the “Expense Report for Exempted Persons.” > Legislators are not required to report scholarships pald by a nonpartisan legislative organization of which the legislator or the General Assembly is a member or participant or an afflate of that organization. Date of ‘Name and Address of Donor(s) Estimated Market Scholarship Value 16. Were you appointed or are you being considered for an appointment to a coverad 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 » Attormey General » Commissioner of Agriculture » Commissioner of Labor » Commissioner of Insurance aves he | 1f “Yes, list all contributions you (NOT immediate family members) made during 2014 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, deposit, distribution, transfer of funds, loan, payment, git, pledge or subscription of money or anVthing of value whatsoever.” = STR 0 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 47. Are you an appointee or prospective appointee to: + the head of prinapal ta department (5. cabinet secretary) appointed by he finbinathd 5. 5 Nok Coan Supreme Court Justice, Court of Appeal, Superior or Distt Court Sudden a member of any of the allowing boars: 360 commission ~ Comsot Resources Commission © Shoe Board of Education Oves Ro Sate Bord of loctions Dion of Employment Security I Nor, proceed to © Enviommenta Menagement Commission uestion 18. Indusral Commission pip —— Rtas Raton Commision Bond of Transportation © URC Board of Governors Uti Commission © Widive Resources Commision Tom, were you sppotad o are you bing corsdered fo apparent t Tat pubic | CJ¥es CINo EE ort meer Coun of te members are 16d m+ | 16 wha’, proceed to Peston Te. Oe. eo you must cate whether during 2014 you (not mediate family members) i of th rowing aches win spect t or on baal of tne pn commmios of the Count Sate memos whe appointed pbb ka [Yes [No 1 Colected contributions from maltile contributors, took pasessio of such Ce eomoehons and anetore or deere sass cacted contutons ene or cmtess” Contains ae dened m Question 16 Cr Vatnteared for campaig elated activites, WhGh include, but a6 no Id to, on etc, ligt, comwassing, avening, or any over | C1¥es CINo RR gh To ave you eve been comicted of a felony for which you have no received Sher: (1) a pardon of nnocenc; or () on ren eam oy com OYes Hho offense Date of Conviction | _ County of Conviction _|_ State of Conviction 5 ve you aware of any athe formation hat you Bleve may 253% th Stte Es Commision n advig you Conca vo comance wih tn Site Government EVs S87 [ives fo 1fyes, please provide such information bet. The SEX and any attachments, excluding the Confidential Form, are public records. Pages or 10 [ArrtrmaTION YL affim that the information provided in this Statement of Economic Interest and any attachments hereto are true, complete, ‘and accurate to the best of my knowledge and belief. 1also certify that I have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it rom diselsurs while retaining a equiabl interes. 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. acknowledge that I have read and understand N.C.G.S. 1384-26 regarding concealing or failing to disclose material information and N.C.G.S. 138A-27 regarding providing false information: §138A-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 on a statement of economic interest under this Article shall be guilty of a Class | misdemeanor and shall be subject to disciplinary action under G.S. 138A-45. § 1384-27. Penalty for false information A fling person who provides false information ona sateen of cconomic inert as required unde his Article knowing that the information is false is guilty of a Class H felony and shall be subject to disciplinary action under G.S. 138A. [2H Agree Begwely dl. Suadett Printed Name Ss EE 34a05 Signature Dats ‘Submit SIGNED, ORIGINAL documents only. Do not fax or email this form. The SET and any attachments, excluding the Confidential Form, are publi records. Page 10 0f 10