Brenda Smith-Williams
Addictions Specialist Professional Practice Board
Filings
2019 Addictions Specialist Professional Practice Board
Document text
R D
= FoR STAY USE ONLY
Gros STATE ETHICS COMMISSION So emes 95 208
(hi y 01s
GH.@/J 2019 STATEMENT OF ECONOMIC INTEREST .
&Z ¥ NCETHICS GRMMISSIO
NO-CHANGE FORM checked tor pion > 48
This entire form must be completed to fulfill your scanned Lo ote olsli]
ethics filing obligation. era Sho
Fler's Name (First, Middle Last
[Brenda] [Smith Wiliama ||
Reason for Filng (Complete al tht apply.
State Government Job (Speciy agency and positon.) | Board/ Commission (Lt the complete names of al State
22rd gn which vou are serving or ae being considered.)
oth Cordina Sulspnce Ahse Pro
Fessiona) Prackine Board
Judicil Officer (Specty office)
AFFIRMATION
The information provided in this Statement of Economic Interest and any attachments are true, complete, and accurate to
the best of my knowledge and baler
have not transferred, and will not transfer, any asset, interest, or property for the purpose of concealing it from disclosure
whi retaining an equitable terest.
understand that my Statement of Economic Interest and any attachments except for the Confidential Form Regarding
Unemancipated Children public records
have read and understand the folowing statutes:
N.C.GS. § 1634-191. Concealing or falling to disclose materia information.
A filing person who knowingly conceal or knowingly falls to discos Information tht s required to be disclosed an
2 statement of cconomic interest Shall be Gui of 3 Class 1 misdemeanor and. subject to disciplinary action
Under G.5. 1634415
N.C.GS. § 1634-192. Penalty for alse information.
A filing person who provides fase information on a statement of economic Interest... Knowing tha th information
is false 1s uly of a iass felony and shall be Subject to disciplinary action under G.5. 163A 415.
1 affirm that I have reviewed my most recently fled 2018 Statement of Economic Interest and that as of
December 31, 2018, my responses continue to be true, correct, and complete to the best of my knowledge and
belief
firm under of perjury that the foregoing is true and correct.
“Tada Go) ans, ))9
Signature [) i : ate
2 conda “2a Williams
Printed Rame
Submit signed, original documents only. Do not fax or e-mail this form.
This entire document is a public record.
2017 Addictions Specialist Professional Practice Board
Document text
LoL NORTH CAROLINA STATE ETHICS COMMISSION [For ERriCS COMPRERIN TROT
& 2017 STATEMENT OF ECONOMIC INTEREST
RECEIVED JUN 19200
NO CHANGE FORM so
THIS ENTIRE FORM MUST BE COMPLETED TO [sce | cue 001 |]
FULFILL YOUR ETHICS FILING OBLIGATION
FILER'S WANE (FIRST, WIODLE, LAST) oo |
Prefix | First Name Middle Name R Last Name [sums |
| REASON FOR FILING (COMPLETE ALL THAT APPLY) or i i EE J
STATE GOVERNMENT JOB (Specify Agency and Position) BOARD/COMMISSION (List the complete name of all State
NE rH, Cote dine, Seimanace thase Pn Stoic OTHE
_.. BNQSAPER |
JUDICIAL OFFICER (Spey Office) | veaisunToR (specty rouse or senate) |
[AFFIRMATION oo - - 1
| complete, and accurate to the best of my knowledge and belief. 1
oO R—
| it from disclosure while retaining an equitable interest.
| 1 understand that my Statement of Economic Interest and any attachments or supplements thereta (with the exception of
Carton Form separa neranci ood Crem vs cord |
5 1398.26, Conceaing or fing o disclose material formation
IT —
| A filing person who provides false information on a statement of ecancmic interest as required under this Article
| GS. 1388-45.
| 1 hereby affiem that I have reviewed my most recently filed 2016 Statement of Economic Interest and that as.
Bett, Boi eons comin bn to, core, 7 PRL 3 sk of reds |
| tng waar |
Stages {
dei U2 Jl Cd Le dvag = a 307
TE — sie ALL i
It: i 3 {
2. NEP [{
span oleae
Submit SIGNED, ORIGINAL documents only. Da not fax or e-mail this form. I.
This entire document is » public record.