CCP 03-27-2012 - Laserfiche WebLink

Home Browse Search

Form 8038-G Information Return for Tax-Exempt Governmental Obligations (Rev.September 2011) ►Under Internal Revenue Code section 149(e) OMB No.1545-0720 O.See separate instructions. Department of the Treasury Caution:If the issue price is under$100,000,use Form 8038-GC. Internal Revenue Service Part I Reporting Authority If Amended Return,check here ► 0 1 Issuer's name 2 Issuer's employer identification number(EIN) 3a Name of person(other than issuer)with whom the IRS may communicate about this return(see instructions) 3b Telephone number of other person shown on 3a 4 Number and street(or P.O.box if mail is not delivered to street address) _I Room/suite 5 Report number(For IRS Use Only)I31 I 6 City,town,or post office,state,and ZIP code 7 Date of issue e Name of issue 9 CUSIP number 10a Name and title of officer or other employee of the issuer whom the IRS may call for more information(see 10b Telephone number of officer or other instructions) employee shown on 10a Part II Type of Issue(enter the issue price).See the instructions and attach schedule. 11 Education 11 12 Health and hospital 12 _ 13 Transportation 13 14 Public safety 14 15 Environment(including sewage bonds) 15 16 Housing 18 17 Utilities 17 18 Other. Describe ► __ _ _ 18 18 If obligations are TANs or RANs,check only box 19a _ ► ❑ If obligations are BANs,check only box 19b ► ❑ 20 If obligations are in the form of a lease or installment sale,check box , . , . , , , , ► ❑ Part III Description of Obligations.Complete for the entire issue for which this form is being filed. (a)Final maturity date (b)Issue price (c)Stated redemption (d)Weighted (e)Yield price at maturity average maturity 21 $ — $ years Part IV Uses of Proceeds of Bond Issue (including underwriters' discount) 22 Proceeds used for accrued interest 22 _ 23 Issue price of entire issue(enter amount from line 21,column(b)) 23 24 Proceeds used for bond issuance costs(Including underwriters'discount). 24 25 Proceeds used for credit enhancement 25 26 Proceeds allocated to reasonably required reserve or replacement fund 26 27 Proceeds used to currently refund prior issues 27 28 Proceeds used to advance refund prior issues 28 29 Total(add lines 24 through 28) 29 30 Nonrefundlng proceeds of the issue(subtract line 29 from line 23 and enter amount here) . . . 30 Part V Description of Refunded Bonds.Complete this part only for refunding bonds. 31 Enter the remaining weighted average maturity of the bonds to be currently refunded , , , . ► years 32 Enter the remaining weighted average maturity of the bonds to be advance refunded . , . . ► years_ 33 Enter the last date on which the refunded bonds will be called(MM/DD/YYYY) ► 34 Enter the date(s)the refunded bonds were Issued►(MM/Do/YVYY) For Paperwork Reduction Act Notice,see separate Instructions. Cat.No,63773S Form 8038-G(Rev.9-2011)