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I. $10,000 PLUS DISCLOSURES <br />If you, your spouse, or members of your immediate family have assets or liabilities with a market value of at least $10,000 in the following categories, <br />please provide the requested information as of December 31" of the preceding year unless another time period is specified in the question. <br />No. Do not list the value of those assets or liabilities. <br />No- Do not list assets or liabilities held in a blind trust' established by or for the benefit of you or an immediate family member. <br />1. Do you, your spouse, or members of your immediate family have an ownership interest in North Carolina real estate with a market value of $10,000 or <br />more? <br />❑ Yes ❑ No <br />Owner of Real Estate <br />% Ownership Interest <br />Location by City <br />Location by County <br />2. Do you, your spouse, or members of your immediate family lease or rent to or from the State real estate with a market value of $10,000 or more? <br />❑ Yes ❑ No <br />Name of Lessor <br />Name of Lessee (Renter) <br />Location by City <br />Location by County <br />3. Within the preceding two years, have you, your spouse, or members of your immediate family sold to or bought from the State personal property with a <br />market value of $10,000 or more? <br />❑ Yes ❑ No <br />Name of Purchaser <br />Name of Seller <br />Type of Property <br />4. Do you, your spouse, or members of your immediate family currently lease or rent to or from the State personal property with a market value of $10,000 <br />or more? <br />❑ Yes ❑ No <br />Name of Lessor <br />Name of Lessee (Renter) <br />Type of Property <br />4 A "blind trust" is a trust that meets all of the following criteria: (a) the owner of the trust's assets has no knowledge of the trust's holdings and sources of income, (b) the individual <br />or entity managing the trust's assets ( "the trustee ") is not a member of the covered person's extended family and is not associated with or employed by the covered person or his or <br />her Immediate family, and (c) the trustee has sole discretion to manage the trust's assets. G.S. 138A -3(1). <br />This entire document and any attachments are public record. <br />Page 2 of 9 <br />Attachment number 4 <br />F -2 Page 78 <br />