Nebraska Accountability and Disclosure Commission

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NEBRASKA ACCOUNTABILITY AND DISCLOSURE COMMISSION 11th Floor, State Capitol P.O. Box 95086 Lincoln, NE 68509 (402) 471-2522

REPORT OF LATE CONTRIBUTION NADC FORM B-5

A political committee receiving a contribution of $1,000 or more during the 14 days immediately preceding an election must file this Report of Late Contribution. A Report of Late Contribution is filed on time if it is postmarked or personally delivered on or before the due date. Late filing fees are either $100 per day, not to exceed $3,000, or 10% of the contribution, whichever is greater.
ITEM 1	NAME AND ADDRESS OF POLITICAL COMMITTEE FILING REPORT
Name WHITEHEAD FOR CITY COUNCIL (DISSOLVED) Telephone No. (402) 488-8578 Address 810 S. 26TH STREET, STE A     LINCOLN     NE     68510
ITEM 2	NATURE OF COMMITTEE
Candidate Committee
ITEM 3	FULL NAME AND ADDRESS OF CONTRIBUTOR
Name SAMPSON JOHN . Telephone No. Address 4100 SALTILLO ROAD     ROCA     NE
ITEM 4	DATE, AMOUNT AND NATURE OF CONTRIBUTION
Nature of Contribution   X Money         Loan         In-Kind         Pledge                 Date Received 05/06/2013     Amount $1500.00
ITEM 5	OCCUPATION, EMPLOYER AND PRINCIPAL PLACE OF BUSINESS OF CONTRIBUTOR
Occupation Employer Principal Place of Business

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