Brian Gregory Campbell

’ , NORTH CAROLINA STATE BOARD OF | FOR COMPLIANCE UNIT USE ONLY H py ELECTIONS AND ETHICS ENFORCEMENT | Date Received: © 4° 2018 STATEMENT OF ECONOMIC INTEREST | WH Checked tor completion 4 Wltseomnes 096 be THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL p erst db YOUR SEI FILING OBLIGATION necputigte 3s: — a Supp. Sent Date 1019.14 By DW Entered in database JG 26 Tay pT [peter | [First Name NET Name Last Name [suix_| Baca~ Gasyery (ANP Be | cunvenr emmLoven Teams 1 Re frac d "Ih _ {| STATE GOVERNMENT JOB (Specify Agency and Position) | BOARD/COMMISSION (List complete name of ll State | i A. Do other immediate family members reside in your household? es TINo siblings, and the spouses of each of those persons) who reside in your household. 1 ist the full name of all adults and emancipated minors in your household. A minor is 3 child under 6 years old —] | FULL Name oF aDuLTS & | RELATIONSHIP | EMPLOYER Tosmme | ature or eece T Conphec was | Rotised | a= T SE EE EE EE I | 1 i ——————— —— ———————— — f5."Lst ONLY the initials o al unemancipated minors in your hausehold below. A minor is 8 cid under 16 years ol. i Note: You must list the full name of each minor child on the Confidential Form available at the | end or this document. " i; INITIALS FOR | RELATIONSHIP EMPLOYER J0BTITLE | NATURE OF UNERANCIPATED | ‘SUsingss |proPeRTY INTERESTS i 1. As of December 31, 2017, did you, your spouse, or members of your immediate family: A. Have an ownership interest in Horth Cardin realestate (Including your resin) witha market value of | $10,000 or more? ives [No | | Owner of Real Estate| on Ownership Interest | Locationby city | _ Location by County | 8. Lease or rent real estate or personal property 10 ar fram the State af North Cargling with 8 market valve of 1 | Ges Oves [30 Name of Lessor I Name of Lessee If Real Estate, Location | If Personal Property, i (Renters by City 8 County Describe ——————————— TC | 2. At any time during 2016.0 2017, did you, your spouse, or members of your immediate family sell to or buy from the | State of North Carolina personal property with a market value of $10,000 or more? | | Ove @fo amcor amet CC — sroperty The SET and any attachments, excluding the Confidential Form, are public records. Page 20110 P———— — _— EE EE | FINANCIAL INTERESTS |/3. As of December 31, 2017, 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. Stak In a publicly owned company? Dyes ho _ > 00 Dat lst ownership interests no widely held investment fund (including mutual funds, regulated investment Companies, or pension or deferred compensation plans) 1: (1) the fund 1 publicly traded or is essets are widely dersified 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 plan. I Owner of Interest |Full Name of Company (Do not use a ticker symbol) | — EE —| | frm mm———— A | 6. Stock Options in a company or business? | Oves Orfio | ‘Owner of Stock Option Full Name of Company (Do not use a ticker symbol) C. Interests n a non-gublcly cued company or business entity (including interests n sole proprietorships, partnrships, mited partnerships, Join venturcs, ited flabity companies, bmted habity partnerships, and closely held corporations)? | Ove @Ro- 110,” proceed to question a. Owner of Interest Name of Company or Business Entity | i i C1). For each non-pubicly owned company or business entity (the “primary company”) identified in question 3.C_above, please is the names of any other companies or business entities in which the primary company. || __ows secures or cqiy interests valued of ovr $10,000, Ana: Non-publicly Owned Company or Business Entity | Other Companies in which the Primary Company | | (the Primary Company) ‘Owns Security or Equity Interests 1 — | [one or ot Known The SET and any attachments, excluding the Confidential Form, are public records. Page 3 of 10 € (2). 11 you know that any company or business enti Isted In 3. or 3.C(1) above has any material business lng o business contracts with te State of North Caroling, or 5 rguated oy th State, prow a oral description of that business activity. | Name of Company or Business Entity Description of Business Activity with the State None or Not Known 4. As of December 31, 2017, 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 oy you? Do not list assets held in blind trusts. See 2017 SEI Helpful Tips for the definition of “Vested Trust” and “Blind Trust.” | Oves @fo ome snags free || omepionat oe ro Your Relationship to the Trust — S— t 5. As of December 31, 2017, did you, your spouse, or members of your immediate family have liabilities of $10,000 or | ore, XGA ThE MrAGsG on Your pHmAry personal eSCHCa” EASES Cog Creat cad debts, aus loans, Student cans, persons loans and mira. farmly debt. Eyes [No Name of Debtor (You, Spouse, Immediate Family | Type of Creditor (Commercial Bank, Credit Union, Member) " Indus, ete) Fey BT 6. List each source of income (not specific amounts) of more than $5,000 received by you, your spouse, or members of your immediate fomiy Sunng 2017. Include soar, Wages. stateiocal Gevermment retremant, professional foes, Honoraria, interest, ddends, canta come, business income, and other pes of Income requires to bé reported on your Stats and federal tx returns. 00 not include income received from the following sources: ! » Capital gains » Federal government retirement ! > Miltary retirement > Social security income SSDI Recipient of Income | Name of Source Type of Type of Income 0d no reportable income over $5,600 1 2017. - — Eun SE 15 SE : Decied cdcety | Karis USA Kodi penendt | ~ Kiev Turk Lopbiat | Clues, Sala The SEX and any attachments, excluding the Confidential Form, are public records. Page dof 10 PROFESSIONAL AND CIVIC RELATIONSHIPS 7(a). During 2017, were you, your spouse or members of your immediate family a director, officer, governing board mertiber, employes, independent contractor, or registered IGbOYISt af 3 nonprofit Corporation o organization operating in the State of North Caroline primarily fo religious, charsable, sient. rary, public héaith and safety, or educational purposes? ves Mo - 10,” proceed to question's [75D not lst 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. Name of Person His/Her Position Name of Nonprofit Nature of Business or Corporation or Organization | Purpose of Organization | I | 1 BR — lL NN EN SE R— | 7(b). Ifthe nonprofit corporations or organizations sted above do business With the State of North Carolina or receive | | State funds, please provide o brief escripon of the nature of that business, f known or with which due dilgence could | reasonably b known. SO — Name of Nonprofit Corporation or Organization | Describe State Business or State Funding £1 None or Nt known 6. Duna 2017, vere vou, your spouse, or members of your mmEdRRE family 3 rector, SHIGE, or Gove 53rd | member of any Society, arganization, or SAVOCAEY Group WIth an INrESE in matters over which your 3géncy of board may Have yursdiction? Cives @Ho Lenton Ofer You ar rc round complet i ues ou aren becuse You are 2 legislator or a judicial oficer or you are fing a5 an appointee to those offices, D0 not lst 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 SEI and any attachments, excluding the Confidential Form, are public records. Page 5 of 10 Sa. U0 no of cath company or bins wh wh You re ase irs your rer of ou Sd [om was an employee, director, officer, partner, proprietor, or member or manager as of December 31, 2017. i Name of Person Relationship to Filer Name of Company i Role of Person J No Business Associations. 20). ow kno Fa ay coy rues Tred 90) oe i — p——— | Bee Cots wt We St of ot Cora a gave he Se oF Samoa 1. S01 ove Name of Company or Business Entity Description of Business Activity with the State | i | 1 ee ————— mm ————————————— JET —— TNR — legal fees of more than $10,000 during 2017. ] [] Administrative [J Admiralty [J Corporate [J Criminal Clot itgston(ncng Cuties eaten (10rber ctor ot te | ea T's. Outi 2037 you 3 eens srossoral ver thn an samen) ar di 700 prove cog eres Cves [Ano I Type of Business 1 Natur o Services Randerea ] The SEL ond any attachments, excluding th Confidential Form, are public records. Pagesotso [12-20 vou or your emptor, your spouse or members of vaur meats fam, or ther ployer current: Licensed by the State board or amploying entity with which you are or wil be associated or | + equated by the State boars or employing entity with which you are or wil be associated or | i» Selatan ith the State bad o ampleying ty with which yo are or wil be esccted? [%er Pio C1 Logsltor/uticial Office You ar nt required o complete this guestion you sre fing becuse | Yours a agar os ulcer (cn shen sabe ne S64 too os ovo | . ret 25 rapped hose ih EE TTT (it applicable) (Licensing, Negulatory, Business) | {13 ou vou Spouse or 3 mero your stats al ny ogre 2 ony a ro | | were you registered as such within the 12 months preceding yaur fing of this form? | | Ove oh I Name of Lobbyist Lobbyist's Principal I" oateof | Registration | | Remmeation | Expteaion |OTHERDISCLOSvRES { 1. During any clendar quae in 2017 (out aly the Gs period afer you were spp, employed or fied or ware | a a non active ars wna Epos Satan orn ere on Se of BSS SS Seine, 20 + when both you and those person(s) were outside North Carolina at the time you accepted the gift(s), and H « the gift(s) were given under circumstances that would lead a reasonable person to conclude that they were given | | torcboying? | Oves who [700 ot ape is 30a ember your extended fly Cupense hepa tor Evermpt persons [Gate Item Received | Name and Address of Danor(s) | Describe tom Received | Estimated Market ! Vo The SEI and any attachments, excluding the Confidential Form, are public records. Page 7 of 10 ['35. During 2017 (but ony the time period afte you were appointed, employed, or fled or were nominated as a candidate) ayo || scent a cholrsn” xceaing 200 rom ern or rp of persons acu tgs and | |< those persons) were autsde North Caroma ant Ir * 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, 648img, meats, and other Star exponen, UU O—— ina 253 cc! sheer spporen. 00 10 report its that have previously been reported by yo othe Deparment of the Secretary of Stat on the Evga Repo or Exerc ersons > Legsators are not required t report scholrshigs pai by nonpartisan legate organization of which th lgiltor oe tal Rese 158 amar 0 POrICPant of 9 hare oft vga, _— | Date of Name and Address of Donor(s) Describe Event | Estimated Market scholarship | Vaiue RE _ [116 Were vou apport o are you being considered or an apparent 0 covered board bv the Governor o ancther | Counc of roe memeers | Council of State members are: » Governor > ut. Governor » Secrtory of Sate Le state Auer + State Treasurer » Superintendent of Publi Instruction » Attomey General » Commissioner of Agriculture» Commissioner of Labor + Commissioner of insurance Oves (fo 1*Yes", lst all contributions you (NOT immediate family members) made during 2017 with a cumulative Total of more than $1,000 to the Governor o other Counch of State member whe sppoIeed you. Gepost, Gatbston, wanes of Tani, Ian, payment SA, BEGG: O Subscipion 1 Meher or Sain afi [Perio Eee. i i:izfz i’ I Date Amount I Contributed to Mo cortribution(s) wit a cumulat fotal of more tna $1,000 ES The SEX and any attachments, excluding the Confidential Form, are public records. Page sof 10 17. Are you an appointee or prospective appointee to: a. the head of a principal state department (e.9. cabinet secretary) appointed by the | i Governor or b. a North Carolina Supreme Court Justice, Court of Appeals, Superior or District Court Judge; or |<. a member of any of the folowing boars: | + ASC Commision | + Coastal Resources Commission i i « State Board of Education Cves [No + State Board of Elections + Division of Employment Security I No proceed to | + Environmental Management Commission question 18. | + Industrial Comission + Human Resources Commission | + Rules Review Commission + UNC Board of Governors | | + Utilities Commission I Wife Resources Commission . | 4150, were you appointed or ae you being consiered fo sppontmant to that | [Ives [Io public postion by a Council of State members Council of tate members are 155d | 17 wg,” proceed to aueston 16. ras, . 1 50, you must indicate whether during 2017 you (not rmmediate family mermbers) gaged in any of the folloming sctiies with respict to of in behalf of | the candidate or campaign committee of the Council of State member who. appointed you to your public poston i ives ho i | i. Collecteg contributions from multiple contributors, took possession of such multiple contributions, and transferred or delered those colected Contributions to the candidate or committea? Contributions are defined in Question 16. i. Hosted a fondraser at your residence or place of business? Oves ho Hi. Volunteered for campaion- related activities, which include, but are not Imited to, phone banks, event assistance, mains, canvassing, surveying. or any |] Yes TrNo | other activity that advances the campaign of & COndOATE? 15. Have you ever been convicted of a felony for which you have not received cher: () 3 pardon of mnocence: or (1) an order of expungement regarding that conviction? | | Ove oe | Offense Date of Conviction County of Conviction State of Conviction 19. Are you aware of any other information that you believe may 35st the State Ethics Commission in advising vou Concerning your complance with the State Government Etnies A> | ves ve 11 yes, please provide such information below. The SEI and any attachments, excluding the Confidential Form, are public records. Page 9 of 10 ee NE — SE AFFIRMATION | | aff that the information provided in thi Statement of Economic Interest and any attachments hereto are te. complete. and accurate to the best of my knowledge and bee | from disclosure while retaining an equisble interest. | understand that my Statement of Economic nerest and any aachents or supplements thereto (with the exception of the Confidential Form reading Unemancipated ilden) are public record. | acknowtadee har ve read and understand N.C... 139A-26 regarding concalivg or fing to disclose matcrial | | formation and N.C... 1384-27 regardmg providing fle formation | $138.26. Conceaing or fling to disclose material information. || A lig person who knowingly conceals or knowingly sil 0 disclose information that i requied tobe disclosed ana statement of economic interest under his Article shall be uly of a Chis 1 misdemeanor and shall b subject o diciplinary action under GS. 138-45 [| s 13327. penaly or tate information lin person who provides fase information on a Statement of ccomomie interest as required under this Aricle Knowing that the informaion i false is guilty of a Class 1 felony and shall be subject to disciplinary action under I ¢ auiy i GS IAS | hm Compliet Bate Barge Co Comp bre 1/ Frmted name The SEX and any attachments, excluding the Confidential Form, are public records. Page 100f 10

FOR COMPLIANCE UNITUSE © + ONLY NORTH CAROLINA STATE BOARD OF ELECTIONS AND ETHICS ENFORCEMENT 2018 STATEMENT OF ECONOMIC INTEREST NO-CHANGE FORM Checked for completion Review sour LAST SELLONG Form CONTACT INFORMATION This contact information page will nox be available on the Commission's website. but it s a public document. THIS ENTIRE FORM MUST BE COMPLETED TO FULFILL SEND YOUR SIGNED ORIGINAL 10: NORTH CAROLINA STATE BOARD OF YOUR ETHICS FILING OBLIGATION ELECTIONS AND ETHICS ENFORCEMENT BY MAN HAND DELIVERY: 1323 MARL SERVICE CENTER The Debi Buikding RALEIGH NC 2769.11.34 150 SALISBURY STREET HD HLOOR RALEIGH, NC 27603 Pre First Name Midi ame ut Na Sty PO fon 1, Fh NC 2501 Adder Cty Stat Zip HONE ADDRESS PROVIDE YOUR HON ADDRESS ONLY IF YOU ARK HO! DING OK SEEKING AX FLEC TD OFFICE WITH A RESIDENCY HEURES. Thi esivcnet doc mt sp Jd Oc Adres Cty State Zi his oie docurcat is 3 publ record +" FOR NORTH CAROLINA STATE BOARD OF COMPLIANCE UNIT USE OMY ELECTIONS AND ETHICS ENFORCEMENT [re— 2018 STATEMENT OF ECONOMIC INTEREST NO CHANGE FORM Scanned Date is ENTIRE FORM MUST BE COMPLETED 10 FULFILL YOUR ETHICS FILING OBLIGATION fuerdin Db BRIAN G. CAMPBELL Pr First Name Mid Name Lit Name Sufix REASON FOR FING (COMPLETE ALL THAT AVRLY 1 STATE GOVERNMENT JOM pect Ascac sun Potions BOARD ONMISSION th erp nae of all tt JDICIAL OFFICER (Specs Ohee) LEGISLATOR pects Hose ao Sn GS 1 RI Gol 75 Signature Date Benn G Canip Zee Primes Name Submit SIGNED, ORIGINAL documents oly Do not or cana) this orn. This entire docoment is « publ record,