| Ethics Commission, North Dakota

Submission information

Submission Number: 152

Submission ID: 27434

Submission UUID: 77527872-e42e-4bc9-a681-c967240a83b6

Submission URI: /Travel-Disclosure

Created: Tue, 09/15/2026 - 18:37

Completed: Tue, 09/15/2026 - 18:37

Changed: Mon, 09/21/2026 - 13:58

Remote IP address: 65.61.75.108

Submitted by: Anonymous

Language: English

Is draft: No

Webform: Travel

Submitted to: Inline block

Submission State Approved

Official’s Information RACHELLE GUSTAFSON

Official’s Position with the State North Dakota State Board of Dental Examiners - Dental Hygienist member

Travel Information

Destination Visited Omaha, NE

Travel Start Date 2026-08-27

Travel End Date 2026-08-29

Purpose of Travel CRDTS Annual meeting with Committee meetings and Education

Source(s) of Expenses Paid (include for lodging and meals) CRDTS - $1122.52 and NDBDE - $671.00

Estimated or Actual Amount Spent for Expenses (include lodging and meals) $$ 1,793.52

Number of Any Accompanying Family Members (if any) 0

Expenses Paid Categories (check all that apply): Air Transportation, Ground Transportation, Lodging, Meals

Certification I certify the information provided in this travel disclosure form is true, correct, complete, and of my own personal knowledge. I further certify I am the public official named or the public official’s authorized representative and will fully cooperate in the process regarding the filing of this travel disclosure form.

Signature (typed name is acceptable) Rachelle Gustafson, RDH, BSDH

Today's Date 2026-09-15

Signature Digital {Empty}

{Empty}

Inline block: Submission #152