OKLAHOMA ETHICS COMMISSION PHONE: (405) 521-3451 • FAX: (405) 521-4905 • WEBSITE: WWW.OK.GOV/ETHICS FINANCIAL DISCLOSURE STATEMENT FOR ELECTED STATE OFFICERS Amended: NO Full Name of State Officer Filing Year Name of State Office Term of Office DAVID PERRYMAN 2015 STATE REPRESENTATIVE, DISTRICT 56 11/23/2016 - 11/22/2018 Electronic Mail Address Work Phone Number Mailing Address, City, State, Zip Code “Elected state officer” shall mean a state officer who is subject to election or retention. I understand that as an elected state officer, as defined above, I am required to comply with the Rules of the Oklahoma Ethics Commission and that, according to the Oklahoma Supreme Court, those Rules have the “weight of statutes." I have read and understand the Conflicts of Interest Rules in Rule 4 of the Ethics Rules. I understand the Ethics Commission rules are available in the Oklahoma Statutes at Title 74, Chapter 62, Appendix I, and on the Ethics Commission website at www.ethics.ok.gov. I understand the Ethics Commission provides continuing education programs, educational materials and is available to answer questions and provide analysis regarding the application of Ethics rules to specific fact situations. 1. Private Gain. I understand that elected state officers cannot use his/her State office (1) for his/her own private gain; (2) for the endorsement of any product, service or enterprise; (3) for the private gain of a family member or person with whom he/she is affiliated in a nongovernmental capacity, including nonprofit organizations of which he/she is a member or officer; or (4) for the private gain of persons with whom he/she is seeking employment or business relations. 2. Solicitation of funds for civic, community or charitable organizations. I understand it is not a misuse of office to promote or solicit funds for civic, community or charitable organizations, including those promoting businesses or industries, or civic, community or charitable fundraising events provided I receive nothing for doing so except the costs associated with the participation in a fund-raising promotion or event paid for from funds of a charitable organization. 3. Use of office, title or authority. I understand an elected state officer cannot use or permit the use of his/her office or title or any authority associated with his/her state office in a manner that is intended to coerce or induce another person, including a subordinate, to provide any benefit, financial or otherwise to the state officer, the family members of the state officer, or person with whom he/she is affiliated in a nongovernmental capacity, except to the extent otherwise permitted or authorized by the Constitution, statutes or by the Ethics Rules. Filing Date: 12/16/2016 11:21:39 AM Printing Date: 3/31/2017 1:06:08 AM PFD Elected Officer Version 2016.1 4. Material Financial Interest. I understand I must disclose, on this form, any material financial interest as defined below, that I, my spouse or my dependent(s) had in the preceding calendar year covering January 1, 2015 through December 31, 2015. A material financial interest shall mean one or more of the interests identified below: an ownership interest in a private business, including but not limited to, a closely held corporation, limited liability company, Subchapter S corporation or partnership for which I, my spouse or my dependent(s) is a director, officer, owner, manager, employee, or agent or any private business, closely held corporation or limited liability company in which I, my spouse or my dependent(s) owns or has owned stock, another form of equity interest, stock options, debt instruments, or has received dividends or income worth $20,000.00 or more; an ownership interest of 5% or more in a publicly traded corporation or other business entity; an ownership interest in a publicly traded corporation or other business entity from which dividends or income, not to include salary, of $50,000.00 or more were derived during the preceding calendar year; an interest that arises as a result of service as a director or officer of a publicly traded corporation or other business entity; income derived from employment, other than compensation pertaining to the office subject to election or retention, in the amount of $20,000.00 or more. Disclose in the table below the name and address of all entities in which you, your spouse or your dependents had a material financial interest in the preceding calendar year, and who has the interest. Filing Date: 12/16/2016 11:21:39 AM Printing Date: 3/31/2017 1:06:08 AM PFD Elected Officer Version 2016.1 Name and Address of Entity Description (optional) RETIREMENT INVESTMENT ADVISORS Filer / Spouse / Dependent FILER 3001 UNITED FOUNDERS BLVD. SUITE A OKLAHOMA CITY, OK 73112 Name and Address of Entity Description (optional) FIRST NATIONAL BANK AND TRUST COMPANY OF CHICKASHA Filer / Spouse / Dependent SPOUSE 302 W CHICKASHA AVE CHICKASHA/OK/73018 Name and Address of Entity Description (optional) LINE CREEK RESOURCES Filer / Spouse / Dependent FILER PO BOX 1181 CHICKASHA/OK/73023 Name and Address of Entity Description (optional) ING/VOYA Filer / Spouse / Dependent SPOUSE 230 PARK AVENUE NEW YORK/NEW YORK/10169 Name and Address of Entity Description (optional) FRAILEY CHAFFIN CORDELL PERRYMAN & STERKEL, LLP Filer / Spouse / Dependent FILER PO BOX 533 CHICKASHA OK 73023 Name and Address of Entity Description (optional) FIRST NATIONAL BANK AND TRUST COMPANY OF CHICKASHA Filer / Spouse / Dependent FILER 302 W CHICKASHA AVE CHICKASHA/OK/73018 Name and Address of Entity Description (optional) MIDFIRST BANK Filer / Spouse / Dependent FILER 228 W CHICKASHA AVE CHICKASHA/OK/73018 Name and Address of Entity Description (optional) FOURTH AND CHOCTAW ASSOCIATES, LLC Filer / Spouse / Dependent FILER PO BOX 533 CHICKASHA/OK/73023 Name and Address of Entity Description (optional) CHICKASHA PUBLIC SCHOOLS Filer / Spouse / Dependent SPOUSE 900 W CHOCTAW AVE CHICKASHA/OK/73018 Name and Address of Entity Description (optional) TINKER FEDERAL CREDIT UNION Filer / Spouse / Dependent SPOUSE 715 METROPOLITAN AVE. OKLAHOMA CITY, OK 73108 Name and Address of Entity Description (optional) OKLAHOMA TEACHER RETIREMENT SYSTEM Filer / Spouse / Dependent SPOUSE P.O. BOX 53524 OKLAHOMA CITY, OK 73152-3524 Name and Address of Entity Description (optional) SEI PRIVATE TRUST Filer / Spouse / Dependent FILER 100 CIDER MILL ROAD OAKS, PA 19456 Amended Financial Disclosure Statement Certification. I certify this amendment is not made for the purpose of reporting information that was intentionally omitted or misstated on the original or previously filed Financial Disclosure Statement. Filing Date: 12/16/2016 11:21:39 AM Printing Date: 3/31/2017 1:06:08 AM PFD Elected Officer Version 2016.1 Acknowledgement: By signing, electronic or otherwise, my name below, I, acknowledge that the information submitted is complete, true and accurate as of the date submitted. I understand the failure to provide such information is a violation of the Ethics Rules of Oklahoma. I understand that I can update the information above at any time by filing an amended Financial Disclosure Statement. 12/16/2016 DAVID PERRYMAN Date Signature Filing Date: 12/16/2016 11:21:39 AM Printing Date: 3/31/2017 1:06:08 AM PFD Elected Officer Version 2016.1