HomeMy WebLinkAbout241008 -- Campaign Finance Report -- Valen CepakCANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT COVER SHEET PG 1
The C/OH Instruction Guide explains how to complete this form.
3 CANDIDATE /
OFFICEHOLDER
NAME
4 CANDIDATE /
OFFICEHOLDER
MAILING
ADDRESS
Change of Address
5 CANDIDATE/
OFFICEHOLDER
PHONE
6 CAMPAIGN
TREASURER
NAME
7 CAMPAIGN
TREASURER
ADDRESS
(Residence or Business)
8 CAMPAIGN
TREASURER
PHONE
9 REPORT TYPE
10 PERIOD
COVERED
11 ELECTION
12 OFFICE
14 NOTICE FROM
POLITICAL
COMMITTEE(S)
Additional Pages
MS / MRS / MR
1 Filer ID (Ethics Commission Filers) 2 Total pages filed:
FIRST MI
VALEN
NICKNAME
LAST SUFFIX
CEPAK
ADDRESS / PO BOX; APT / SUITE #; CITY: STATE; ZIP CODE
AREA CODE
PHONE NUMBER EXTENSION
(
MS / MRS / MR
FIRST MI
LUIS
OFFICE USE ONLY
Date Received
Date Hand -delivered or Date Postmarked
Receipt #
A Date Processed
NICKNAME
LAST SUFFIX
FONCERRADA PASCAL
STREET ADDRESS (NO PO BOX PLEASE); APT / SUITE #; CITY;
Date Imaged
Amount $
STATE:: ZIP CODE
1900 DARTMOUTH F1 COLLEGE STATION TX 77840
AREA CODE
( 979
P
P
January 15
July 15
PHONE NUMBER EXTENSION
777 0530
▪ 30th day before election
8th day before election
▪ Runoff
▪ Exceeded Modified
Reporting Limit
15th day after campaign
treasurer appointment
(Officeholder Only)
Final Report (Attach C/OH - FR)
Month Day Year Month Day Year
7 / 17 /24
ELECTION DATE
Month Day Year
11 / 5 / 24 I -
OFFICE HELD (if any)
THROUGH 10 / 7 / 24
✓ ELECTION TYPE
Primary I Runoff I Other
Description
General • Special
13 OFFICE SOUGHT (if known)
PLACE 3 COLLEGE STATION CITY COUNCIL
THIS BOX IS FOR NOTICE OF POLITICAL CONTRIBUTIONS ACCEPTED OR POLITICAL EXPENDITURES MADE BY POLITICAL COMMITTEES TO SUPPORT
THE CANDIDATE / OFFICEHOLDER. THESE EXPENDITURES MAY HAVE BEEN MADE WITHOUT THE CANDIDATE'S OR OFFICEHOLDER'S KNOWLEDGE OR
CONSENT. CANDIDATES AND OFFICEHOLDERS ARE REQUIRED TO REPORT THIS INFORMATION ONLY IF THEY RECEIVE NOTICE OF SUCH EXPENDITURES.
COMMITTEE TYPE
▪ GENERAL
▪ SPECIFIC
COMMITTEE NAME
COMMITTEE ADDRESS
COMMITTEE CAMPAIGN TREASURER NAME
COMMITTEE CAMPAIGN TREASURER ADDRESS
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CANDIDATE / OFFICEHOLDER FORM C/OH
CAMPAIGN FINANCE REPORT
15 C/OH NAME
VALEN CEPAK
17 CONTRIBUTION
TOTALS
EXPENDITURE
TOTALS
CONTRIBUTION
BALANCE
OUTSTANDING
LOAN TOTALS
18 SIGNATURE
1. TOTAL UNITEMIZED POLITICAL CONTRIBUTIONS (OTHER THAN
PLEDGES, LOANS, OR GUARANTEES OF LOANS, OR
CONTRIBUTIONS MADE ELECTRONICALLY)
2. TOTAL POLITICAL CONTRIBUTIONS
(OTHER THAN PLEDGES, LOANS, OR GUARANTEES OF LOANS)
3. TOTAL UNITEMIZED POLITICAL EXPENDITURE.
4. TOTAL POLITICAL EXPENDITURES
5. TOTAL POLITICAL CONTRIBUTIONS MAINTAINED AS OF THE LAST DAY $
OF REPORTING PERIOD
6. TOTAL PRINCIPAL AMOUNT OF ALL OUTSTANDING LOANS AS OF THE
LAST DAY OF THE REPORTING PERIOD $
COVER SHEET PG 2
16 Filer ID (Ethics Commission Filers)
$
$
$
360.00
360.00
316.00
316.00
44.00
I swear, or affirm, under penalty of perjury, that the accompanying report is true and correct and includes all information
required to be reported by me under Title 15, Election Code.
Signature of Candidate or Officeholder
Please complete either option below:
(1) Affidavit
NOTARY STAMP/SEAL
Sworn to and subscribed before me by
20 , to certify which, witness my hand and seal of office.
Signature of officer administering oath
Printed name of officer administering oath
this the day of
Title of officer administering oath
OR
(2) Unsworn Declaration
My name is VALEN CEPAK
My address is
(street)
Executed in BRAZOS County, State of TEXAS
Forms provided by Texas Ethics Commission
and my date of birth is 09/24/1998
COLLEGE STATION TX 77840 USA
(city)
, on the 7
www.ethics.state.tx.us
(state) (zip code)
OCTOBER 2024
th)
Signature of angate/Officeholder (Declarant)
Revised 1/1/2024
(country)
SUBTOTALS - C/OH FORM C/OH
COVER SHEET PG 3
19 FILER NAME
VALEN CEPAK
21 SCHEDULE SUBTOTALS
NAME OF SCHEDULE
20 Filer ID (Ethics Commission Filers)
SUBTOTAL
AMOUNT
1. • SCHEDULE AI: MONETARY POLITICAL CONTRIBUTIONS $ 360.00
2. SCHEDULE A2: NON -MONETARY (IN -KIND) POLITICAL CONTRIBUTIONS $ 0.00
3. SCHEDULE B: PLEDGED CONTRIBUTIONS $
4. SCHEDULE E: LOANS $
5. SCHEDULE F1: POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $ 316.00
6. SCHEDULE F2: UNPAID INCURRED OBLIGATIONS $
7. SCHEDULE F3: PURCHASE OF INVESTMENTS MADE FROM POLITICAL CONTRIBUTIONS $
8. SCHEDULE F4: EXPENDITURES MADE BY CREDIT CARD $
9. SCHEDULE G: POLITICAL EXPENDITURES MADE FROM PERSONAL FUNDS $
10. SCHEDULE H: PAYMENT MADE FROM POLITICAL CONTRIBUTIONS TO A BUSINESS OF C/OH $
11. SCHEDULE I: NON -POLITICAL EXPENDITURES MADE FROM POLITICAL CONTRIBUTIONS $
12. SCHEDULE K: INTEREST, CREDITS, GAINS, REFUNDS, AND CONTRIBUTIONS RETURNED $
TO FILER
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MONETARY POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
2 FILER NAME
VALEN CEPAK
4 Date
5 Full name of contributor out-of-state PAC (ID#
BRYAN CEPAK
07/18/2024
6 Contributor address; City; State; Zip Code
705 TALL PINES FRIENDSWOOD TX 77546
8 Principal occupation / Job title (See Instructions)
Principal
Date
07/18/2024
SCHEDULE Al
1 Total pages Schedule Al:
3 Filer ID (Ethics Commission Filers)
7 Amount of contribution ($)
9 Employer (See Instructions)
Cepak Holdings, Lp
Full name of contributor out-of-state PAC (ID#:
WENDY CEPAK
Contributor address; City; State; Zip Code
202 DUBLIN CIR APT D LAFYETTE LA 70507
Principal occupation / Job title (See Instructions)
Small Business consultant
Date
Employer (See Instructions)
Self employed
Full name of contributor out-of-state PAC (ID#
MARGARET RICHARD
08/04/2024
Contributor address;
City; State; Zip Code
111 SPRINGSTEEN LN LAFYETTE LA 70507
Principal occupation / Job title (See Instructions)
retired
Date
09/26/2024
Full name of contributor
SARKIS MESERLIAN
Employer (See Instructions)
retired
out-of-state PAC (ID#:
Contributor address;
City; State; Zip Code
1146 ELIZABETH AVE WEST PALM BEACH FL 33401
Principal occupation / Job title (See Instructions)
owner
Employer (See Instructions)
Legacy Tattoo lounge
200.00
Amount of contribution ($)
25.00
Amount of contribution ($)
35.00
Amount of contribution ($)
100.00
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
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NON -MONETARY (IN -KIND) POLITICAL
CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
SCHEDULE A2
1 Total pages Schedule A2:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED IN -KIND POLITICAL CONTRIBUTIONS $
5 Date
6 Full name of contributor ❑ out-of-state PAC (ID#:
7 Contributor address;
City; State; Zip Code
8 Amount of 1 g In -kind contribution
Contribution $ description
Check if travel outside of Texas. Complete Schedule T.
10 Principal occupation / Job title (FOR NON-JUDICIAL)(See Instructions) 11 Employer (FOR NON-JUDICIAL)(See Instructions)
12 Contributor's principal occupation (FOR JUDICIAL) 13 Contributor's job title (FOR JUDICIAL) (See Instructions)
14 Contributor's employer/law firm (FOR JUDICIAL) 15 Law firm of contributor's spouse (if any) (FOR JUDICIAL)
16 If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Date
Full name of contributor ❑ out-of-state PAC (ID#:
Contributor address;
City; State; Zip Code
Principal occupation / Job title (FOR NON -JUDICIAL) (See Instructions)
Contributor's principal occupation (FOR JUDICIAL)
Contributor's employer/law firm (FOR JUDICIAL)
If contributor is a child, law firm of parent(s) (if any) (FOR JUDICIAL)
Amount of In -kind contribution
Contribution $ description
Check if travel outside of Texas. Complete Schedule T.
Employer (FOR NON-JUDICIAL)(See Instructions)
Contributor's job title (FOR JUDICIAL) (See Instructions)
Law firm of contributor's spouse (if any) (FOR JUDICIAL)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
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PLEDGED CONTRIBUTIONS SCHEDULE B
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
2 FILER NAME
4 TOTAL OF UNITEMIZED PLEDGES
5 Date
6 Full name of pledgor ❑ out-of-state PAC (ID#:
1 Total pages Schedule B:
3 Filer ID (Ethics Commission Filers)
1 8 Amount I 9 In -kind contribution
of Pledge $ description
7 Pledgor address;
10 Principal occupation / Job title (See Instructions)
Date
City; State; Zip Code
Check if travel outside of Texas. Complete Schedule T.
11 Employer (See Instructions)
Full name of pledgor ❑ out-of-state PAC (ID#: ) Amount
of Pledge $
Pledgor address;
Principal occupation / Job title (See Instructions)
Date
City; State; Zip Code
In -kind contribution
description
Check if travel outside of Texas. Complete Schedule T.
Employer (See Instructions)
Full name of pledgor ❑ out-of-state PAC (ID#: ) Amount of
Pledge $
Pledgor address;
Principal occupation / Job title (See Instructions)
Date
City; State; Zip Code
Full name of pledgor ❑ out-of-state PAC (ID#:
In -kind contribution
description
Check if travel outside of Texas. Complete Schedule T.
Employer (See Instructions)
Pledgor address;
Principal occupation / Job title (See Instructions)
City; State; Zip Code
Amount of
Pledge $
In -kind contribution
description
Check if travel outside of Texas. Complete Schedule T.
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If contributor is out-of-state PAC, please see Instruction guide for additional reporting requirements.
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LOANS SCHEDULE E
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule E:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED LOANS $
5 Date of loan
6 Is lender
a financial
Institution?
YFN
7 Name of lender ❑ out-of-state PAC (ID#:
8 Lender address;
City; State; Zip Code
12 Principal occupation / Job title (See Instructions) 13 Employer (See Instructions)
14 Description of Collateral 15
none
16 GUARANTOR
INFORMATION
not applicable
9 Loan Amount ($)
10 Interest rate
11 Maturity date
Check if personal funds were deposited into political
account (See Instructions)
17 Name of guarantor 19 Amount Guaranteed ($)
18 Guarantor address;
20 Principal Occupation (See Instructions)
Date of loan
Is lender
a financial
Institution?
r
I Y N
City; State; Zip Code
21 Employer (See Instructions)
Name of lender ❑ out-of-state PAC (ID#:
Lender address;
City; State; Zip Code
Principal occupation / Job title (See Instructions) Employer (See Instructions)
Description of Collateral
none
GUARANTOR
INFORMATION
not applicable
Loan Amount ($)
Interest rate
Maturity date
Check if personal funds were deposited into political
account (See Instructions)
Name of guarantor Amount Guaranteed ($)
Guarantor address;
Principal Occupation (See Instructions)
City; State; Zip Code
Employer (See Instructions)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
If lender is out-of-state PAC, please see Instruction guide for additional reporting requirements.
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POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense
Accounting/Banking
Consulting Expense
Contributions/Donations Made By
Candidate/Officeholder/Political Committee
Credit Card Payment
Event Expense
Fees
Food/Beverage Expense
Gift/Awards/Memorials Expense
Legal Services
Loan Repayment/Reimbursement
Office Overhead/Rental Expense
Polling Expense
Printing Expense
Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
4 Date 5 Payee name
6 Amount ($) 7 Payee address;
8
PURPOSE
OF
EXPENDITURE
9 Complete ONLY if direct
expenditure to benefit C/OH
Date
10/01 /2024
Amount ($)
20.00
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
10/04/2024
Amount ($)
23.28
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
City;
(a) Category (See Categories listed at the top of this schedule) (b) Description
(c)
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
SCHEDULE F1
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought
Office held
Payee name
FROST BANK
Payee address; City; State; Zip Code
4425 STATE HWY 6, COLLEGE STATION, TEXAS 77840
Category (See Categories listed at the top of this schedule) Description
ACCOUNT FEES
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
VALEN CEPAK
Payee name
THE HOME DEPOT
Check if Austin, TX, officeholder living expense
Office sought
COLLEGE STATION CITY COUNCIL
Office held
Payee address; City; State; Zip Code
1615 UNIVERSITY DR E, COLLEGE STATION, TEXAS 77840
Category (See Categories listed at the top of this schedule)
SIGNS
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
VALEN CEPAK
Description
T POST
Check if Austin, TX, officeholder living expense
Office sought
COLLEGE STATION CITY COUNCIL
Office held
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UNPAID INCURRED OBLIGATIONS
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement
Accounting/Banking Fees Office Overhead/Rental Expense
Consulting Expense Food/Beverage Expense Polling Expense
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense
Candidate/Officeholder/Political Committee Legal Services Salaries/VVages/Contract Labor
1 Total pages Schedule F2:
The Instruction Guide explains how to complete this form.
SCHEDULE F2
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED UNPAID INCURRED OBLIGATIONS $
5 Date 6 Payee name
7 Amount ($) 8 Payee address;
9 TYPE OF
EXPENDITURE
10
PURPOSE
OF
EXPENDITURE
11 Complete ONLY if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address;
Political n Non -Political
City;
(a) Category (See Categories listed at the top of this schedule) (b) Description
(c)
State; Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
TYPE OF
EXPENDITURE
PURPOSE
OF
EXPENDITURE
Candidate / Officeholder name
Office sought Office held
I- Political Non -Political
City;
Category (See Categories listed at the top of this schedule) Description
State; Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C/OH
Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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PURCHASE OF INVESTMENTS MADE
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
1 Total pages Schedule F3:
The Instruction Guide explains how to complete this form.
SCHEDULE F3
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date
Date
5 Name of person from whom investment is purchased
6 Address of person from whom investment is purchased; City; State; Zip Code
7 Description of investment
8 Amount of investment ($)
Name of person from whom investment is purchased
Address of person from whom investment is purchased; City; State; Zip Code
Description of investment
Amount of investment ($)
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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EXPENDITURES MADE BY CREDIT CARD
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 10(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement
Accounting/Banking Fees Office Overhead/Rental Expense
Consulting Expense Food/Beverage Expense Polling Expense
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense
Candidate/Officeholder/Political Committee Legal Services Salaries/Wages/Contract Labor
SCHEDULE F4
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
The Instruction Guide explains how to complete this form. USE A NEW PAGE FOR EACH CREDIT CARD ISSUER
1 TOTAL PAGES
SCHEDULE F4:
2 FILER NAME 3 FILER ID (Ethics Commission Filers)
4 TOTAL OF UNITEMIZED EXPENDITURES CHARGED TO A CREDIT CARD $
5 CREDIT CARD
ISSUER
6 PAYMENT
7 PAYEE
8 PURPOSE OF
EXPENDITURE
• Political
▪ Non -Political
9 Complete ONLY if direct
expenditure to benefit C/OH
Name of financial institution
(a) Amount Charged
(a) Payee name
(b) Date Expenditure Charged
(c) Date(s) Credit Card Issuer Paid
(b) Payee address;
(a) Category (See Categories listed at the top of this schedule)
(c) Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
PAYMENT (a) Amount Charged
PAYEE (a) Payee name
PURPOSE OF
EXPENDITURE
I— Political
Non -Political
Complete ONLY if direct
expenditure to benefit C/OH
PAYMENT
PAYEE
PURPOSE OF
EXPENDITURE
I— Political
✓ Non -Political
(b) Description
City, State, Zip Code
Check if Austin, TX, officeholder living expense
Office Sought Office Held
(b) Date Expenditure Charged
(c) Date(s) Credit Card Issuer Paid
(b) Payee address;
(a) Category (See Categories listed at the top of this schedule)
(b) Description
(c) Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name Office Sought
(a) Amount Charged
(a) Payee name
(b) Date Expenditure Charged
City, State, Zip Code
Check if Austin, TX, officeholder living expense
(c) Date(s) Credit Card Issuer Paid
(b) Payee address;
(a) Category (See Categories listed at the top of this schedule)
(c)
(b) Description
Office Held
City, State, Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C/OH
Office Sought Office Held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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POLITICAL EXPENDITURES MADE FROM
PERSONAL FUNDS
If the requested information is not applicable, DO NOT include this page in the report.
Advertising Expense
Accounting/Banking
Consulting Expense
Contributions/Donations Made By
Candidate/Officeholder/Political Committee
Credit Card Payment
EXPENDITURE CATEGORIES FOR BOX 8(a)
Event Expense
Fees
Food/Beverage Expense
Gift/Awards/Memorials Expense
Legal Services
Loan Repayment/Reimbursement
Office Overhead/Rental Expense
Polling Expense
Printing Expense
Salaries/VVages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule G: 2 FILER NAME
4 Date 5 Payee name
6 Amount ($) 7 Payee address;
8
Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
(a) Category (See Categories listed at the top of this schedule)
(C) Check if travel outside of Texas. Complete Schedule T.
9 Candidate / Officeholder name
Complete ONLY if direct
expenditure to benefit C/OH
Date Payee name
Amount ($) Payee address;
Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
Reimbursement from
political contributions
intended
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Category (See Categories listed at the top of this schedule)
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
Payee name
Payee address;
Category (See Categories listed at the top of this schedule)
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
City;
(b) Description
SCHEDULE G
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought Office held
City;
Description
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought
City;
Description
Office held
State; Zip Code
Check if Austin, TX, officeholder living expense
Office sought Office held
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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PAYMENT MADE FROM POLITICAL CONTRIBUTIONS
TO A BUSINESS OF C/OH
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense Loan Repayment/Reimbursement
Accounting/Banking Fees Office Overhead/Rental Expense
Consulting Expense Food/Beverage Expense Polling Expense
Contributions/Donations Made By Gift/Awards/Memorials Expense Printing Expense
Candidate/Officeholder/Political Committee Legal Services SalariesNVages/Contract Labor
Credit Card Payment
The Instruction Guide explains how to complete this form.
1 Total pages Schedule H: 2 FILER NAME
4 Date
6 Amount ($)
8
PURPOSE
OF
EXPENDITURE
SCHEDULE H
Solicitation/Fundraising Expense
Transportation Equipment& Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
5 Business name
7 Business address; City; State; Zip Code
9 Complete ONLY if direct
expenditure to benefit C/OH
(a) Category (See Categories listed at the top of this schedule) (b) Description
(c) Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name Office sought Office held
Date Business name
Amount ($) Business address;
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Date
Amount ($)
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
City;
Category (See Categories listed at the top of this schedule) Description
State; Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name
Business name
Business address;
Office sought Office held
City;
Category (See Categories listed at the top of this schedule) Description
State; Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name
Office sought Office held
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NON -POLITICAL EXPENDITURES
MADE FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
1 Total pages Schedule I: 2 FILER NAME
4 Date
5 Payee name
6 Amount ($) 7 Payee address;
8
PURPOSE
OF
EXPENDITURE
City
SCHEDULE
3 Filer ID (Ethics Commission Filers)
State Zip Code
(a) Category (See instructions for examples of acceptable (b) Description (See instructions regarding type of information
categories.) required.)
Date Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
City
State Zip Code
Category (See instructions for examples of acceptable Description (See instructions regarding type of information
categories.) required.)
Date Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
Date
City
State Zip Code
Category (See instructions for examples of acceptable Description (See instructions regarding type of information
categories.) required.)
Payee name
Amount ($) Payee address;
PURPOSE
OF
EXPENDITURE
City
State Zip Code
Category (See instructions for examples of acceptable Description (See instructions regarding type of information
required.)
categories.)
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INTEREST, CREDITS, GAINS, REFUNDS, AND
CONTRIBUTIONS RETURNED TO FILER
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
SCHEDULE K
1 Total pages Schedule K:
2 FILER NAME 3 Filer ID (Ethics Commission Filers)
4 Date
Date
Date
Date
5 Name of person from whom amount is received
6 Address of person from whom amount is received; City; State; Zip Code
8 Amount ($)
7 Purpose for which amount is received Check if political contribution returned to filer
Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Amount ($)
Purpose for which amount is received Check if political contribution returned to filer
Name of person from whom amount is received
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received
Name of person from whom amount is received
Amount ($)
Check if political contribution returned to filer
Amount ($)
Address of person from whom amount is received; City; State; Zip Code
Purpose for which amount is received Check if political contribution returned to filer
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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IN -KIND CONTRIBUTIONS OR POLITICAL EXPENDITURES
FOR TRAVEL OUTSIDE OF TEXAS
If the requested information is not applicable, DO NOT include this page in the report.
The Instruction Guide explains how to complete this form.
2 FILER NAME
4 Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
SCHEDULE T
1 Total pages Schedule T:
3 Filer ID (Ethics Commission Filers)
5 Contribution / Expenditure reported on:
Cj Schedule A2 C Schedule B E Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 ❑ Schedule F4 C Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B-SS
6 Dates of travel
7 Name of person(s) traveling
8 Departure city or name of departure location
9 Destination city or name of destination location
10 Means of transportation
11 Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
❑ Schedule A2 L Schedule B C Schedule B(J) ❑ Schedule C2 ❑ Schedule D ❑ Schedule F1
❑ Schedule F2 L Schedule F4 C Schedule G ❑ Schedule H ❑ Schedule COH-UC ❑ Schedule B-SS
Dates of travel
Means of transportation
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Purpose of travel (including name of conference, seminar, or other event)
Name of Contributor / Corporation or Labor Organization / Pledgor / Payee
Contribution / Expenditure reported on:
I Schedule A2 ❑ Schedule B ❑ Schedule B(J) Schedule C2 ❑ Schedule D
▪ Schedule F2 n Schedule F4 n Schedule G Schedule H ❑ Schedule COH-UC
Dates of travel
Means of transportation
Name of person(s) traveling
Departure city or name of departure location
Destination city or name of destination location
Purpose of travel (including name of conference, seminar, or other event)
I Schedule F1
Schedule B-SS
ATTACH ADDITIONAL COPIES OF THIS SCHEDULE AS NEEDED
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CANDIDATE / OFFICEHOLDER REPORT:
DESIGNATION OF FINAL REPORT
1 C/OH NAME
3 SIGNATURE
FORM C/OH - FR
The Instruction Guide explains how to complete this form.
•• Complete only if "Report Type" on page 1 is marked "Final Report" ••
2 Filer ID (Ethics Commission Filers)
I do not expect any further political contributions or political expenditures in connection with my candidacy. I understand that
designating a report as a final report terminates my campaign treasurer appointment. I also understand that I may not accept any
campaign contributions or make any campaign expenditures without a campaign treasurer appointment on file.
Signature of Candidate / Officeholder
4 FILER WHO IS NOT AN OFFICEHOLDER
•• Complete A & B below only if you are not an officeholder. ••
A. CAMPAIGN FUNDS
Check only one:
I do not have unexpended contributions or unexpended interest or income earned from political contributions.
I have unexpended contributions or unexpended interest or income earned from political contributions. I understand that I
may not convert unexpended political contributions or unexpended interest or income earned on political contributions to
personal use. I also understand that I must file an annual report of unexpended contributions and that I may not retain
unexpended contributions or unexpended interest or income earned on political contributions longer than six years after
filing this final report. Further, I understand that I must dispose of unexpended political contributions and unexpended
interest or income earned on political contributions in accordance with the requirements of Election Code, § 254.204.
B. ASSETS
Check only one:
I do not retain assets purchased with political contributions or interest or other income from political contributions.
I do retain assets purchased with political contributions or interest or other income from political contributions. I understand
that I may not convert assets purchased with political contributions or interest or other income from political contributions to
personal use. I also understand that I must dispose of assets purchased with political contributions in accordance with the
requirements of Election Code, § 254.204.
Signature of Candidate
5 OFFICEHOLDER
•• Complete this section only if you are an officeholder ••
I am aware that I remain subject to filing requirements applicable to an officeholder who does not have a campaign treasurer on
file. I am also aware that I will be required to file reports of unexpended contributions if, after filing the last required report as
an officeholder, I retain political contributions, interest or other income from political contributions, or assets purchased with
political contributions or interest or other income from political contributions.
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Signature of Officeholder
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POLITICAL EXPENDITURES MADE
FROM POLITICAL CONTRIBUTIONS
If the requested information is not applicable, DO NOT include this page in the report.
EXPENDITURE CATEGORIES FOR BOX 8(a)
Advertising Expense Event Expense
Accounting/Banking Fees
Consulting Expense Food/Beverage Expense
Contributions/Donations Made By Gift/Awards/Memorials Expense
Candidate/Officeholder/Political Committee Legal Services
Credit Card Payment
Loan Repayment/Reimbursement
Office Overhead/Rental Expense
Polling Expense
Printing Expense
Salaries/Wages/Contract Labor
The Instruction Guide explains how to complete this form.
1 Total pages Schedule F1: 2 FILER NAME
VALEN CEPAK
4 Date 5 Payee name
COPY CORNER
6 Amount ($) 7 Payee address;
8
23.82
PURPOSE
OF
EXPENDITURE
9 Complete ONLY if direct
expenditure to benefit C/OH
City;
SCHEDULE F1
Solicitation/Fundraising Expense
Transportation Equipment & Related Expense
Travel In District
Travel Out Of District
Other (enter a category not listed above)
3 Filer ID (Ethics Commission Filers)
2307 TEXAS AVE S, COLLEGE STATION, TX 77840
(a) Category (See Categories listed at the top of this schedule) (b) Description
State; Zip Code
PRINTING CAMPAIGN BUSINESS CARDS
(c)
Check if travel outside of Texas. Complete Schedule T.
Candidate / Officeholder name
Check if Austin, TX, officeholder living expense
Office sought Office held
VALEN CEPAK COLLEGE STATION CITY COUNCIL
Date Payee name
AMAZON
Amount ($) Payee address;
23.54
PURPOSE
OF
EXPENDITURE
City;
410 TERRY AVENUE, NORTH SEATTLE, WA 98109
Category (See Categories listed at the top of this schedule) Description
PRINTING NAME PLATE
State; Zip Code
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Complete ONLY if direct Candidate / Officeholder name
expenditure to benefit C/OH VALEN CEPAK
Date
09/30/2024
Amount ($)
227.33
PURPOSE
OF
EXPENDITURE
Complete ONLY if direct
expenditure to benefit C/OH
Payee name
C.C. CREATIONS
Payee address;
Office sought Office held
COLLEGE STATION CITY COUNCIL
City;
State; Zip Code
114 HOLLEMAN DRIVE, COLLEGE STATION, TEXAS 77840
Category (See Categories listed at the top of this schedule) Description
CAMPAIGN SIGNS
LARGE CAMPAIGN SIGNS
Check if travel outside of Texas. Complete Schedule T. Check if Austin, TX, officeholder living expense
Candidate / Officeholder name
VALEN CEPAK
Office sought Office held
COLLEGE STATION CITY COUNCIL
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