picture of Mount Mansfield

​​​​​Jericho Underhill Water District Underhill, VT

Special meeting 5-18-15

all minutes are in draft form

 

Jericho-Underhill Water District

P.O. Box 174

Underhill, Vermont 05489

 

7:00 p.m.

Basement of the United Church of Underhill

TRUSTEES PRESENT          OPERATORS PRESENT          GUEST PRESENT

Peter Mitchell                                     Marc Maheux                                                                          Jason Ritter                                                      

                                                                                                                                                                                                                     

 CLERK                                      ASST.  OPERATOR                               

  Jane Maheux                                Mike Willard  

                                                             

    Special Meeting Monday May 18, 2015

 

 1.    Peter called the meeting to order at 7:00. Jason made a motion to adopt the Agenda with the addition of the Merchants Bank Loan papers to sign, the Board approved the Agenda.

 

 2.    The proposals were discussed in more detail: Peter, Marc and Jason meet with Aldrich & Elliott they said they would be able to do this for next construction season and we should have a Bond Vote after final design in early spring. Bond vote would be approximately February or March. If you get information ready for early spring we will be in a better cycle for contractor’s quotes. Marc checked Aldrich & Elliot’s references there was nothing negative from any one and their estimating was very close to actual. Jason moved to award the contract to Aldrich & Elliott since they have the most relevant experience to what we are doing and it would benefit us greatly. The motion was unanimously approved. Peter will contact all 3 and let them know.

 

3. A. Peter filled out the paper work to get us on the Priority List with the State and it has been submitted so we are now on their list.

 

    B. The Line of Credit papers were signed from the Merchants Bank. Jason made a motion to go ahead and convert the line of credit to a loan as soon as we know the actual amount we will be using. This motion was approved.

 

 4. Meeting Adjourned: Meeting adjourned at 8:00 PM

 

Respectfully submitted,

 

Jane Maheux clerk/ treasurer                              -----------------------------------------

                                                                                                   Peter Mitchell President

 

 

 

 

 

 

Merchants BANK

 

Note 1 of 1                                                                                                                                                           $75,000.00

Jericho Underhill Water District
LINE OF CREDIT
CURRENT EXPENSE NOTE
1160114137

Jericho Underhill Water District, Vermont                                                                                              May 20, 2015

On May 19, 2016 for value received, the Jericho Underhill Water District promises to pay to MERCHANTS BANK, or order, the principal sum of:

SEVENTY FIVE THOUSAND AND 00/100 DOLLARS $75,000.00

so much thereof as may be advanced hereunder, with interest at the rate of 2.20% per annum, calculated on an actual 365 day year from the date of each such advance, with principal and interest payable in lawful money of the United States at the office of MERCHANTS BANK, in the City of South Burlington, Vermont. Principal and interest may be prepaid in whole or in part prior to the above maturity date.

This Current Expense Note (the "Note") evidences a straight line of credit. Once the total amount of principal has been advanced, the Issuer is not entitled to further loan advances. Advances under this Note may be requested either orally or in writing by the Issuer or as provided in this paragraph. Lender may, but need not, require that all oral requests be confirmed in writing. All communications, instructions, or directions by telephone or otherwise to Lender arc to be directed to Lender's office shown above. The following person or persons are authorized to request advances and authorize payments under the line of credit until Lender receives from the Issuer, at Lender's address shown above,

written                 notice                   of                  revocation                    of                  such                  authority:

________________________________________________ . The Issuer agrees to be liable for all sums either: (A) advanced in accordance with the instructions of an authorized person or (B) credited to any of Issuer's accounts with Lender. The unpaid principal balance owing on this Note at any time may be evidenced by endorsements on this Note or by Lender's internal records, including daily computer print-outs. Lender will have no obligation to advance funds under this Note if: (A) Issuer is in default under the teinis of this Note or any agreement that the Issuer has with Lender, including any agreement made in connection with the signing of this Note; (B) Issuer ceases doing business or is insolvent; (C) Issuer has applied funds provided pursuant to this Note for purposes other than those authorized by Lender.

 

 

This Note is issued to defray the cost of current expenses accrued or incurred in the delivery of governmental services and functions, pursuant to a resolution adopted by the

 

legislative body of the Issuer at a meeting thereof duly noticed, called and held Board of Trustees.

It is hereby certified and recited that all acts, conditions and things required to be done precedent to and in the issuance of this Note have been done, have happened, and have been performed in regular and due form as required by law and that the full faith and credit of the Issuer are hereby irrevocably pledged for the payment of this Note.

Dated May 20, 2015                                                        Jericho Underhill Water District

 

 

 

 

Treasurer                                                                            Board of Trustees Or a Majority Thereof

 

 

 

Jericho Underhill Water District
RESOLUTION

CURRENT EXPENSE BORROWING

WHEREAS, the Board of Trustees is authorized and empowered to borrow money on the credit of the Jericho Underhill Water District to defray the cost of paying current expenses incurred and accrued for the delivery of governmental services and functions incurred and accrued for the delivery of governmental services and functions; and

WHEREAS, it is hereby found and determined that in order to carry out the responsibilities placed upon the Board of Trustees by law, it is necessary and expedient for the Jericho Underhill Water District to meet current expenses; and

WHEREAS, the Jericho Underhill Water District has been and is now providing essential governmental services and funds are needed to meet expenses relating to the delivery thereof; and

WHEREAS, current funds are not available to pay in full incurred and accrued current expenses and it is necessary for the Board of Trustees to borrow money on the credit of the Jericho Underhill Water District for such purpose; and

WHEREAS, in order to have funds available to meet current expenses as aforesaid, the Board of Trustees has arranged to borrow $75,000.00 from MERCHANTS BANK, with such borrowing evidenced by a single Current Expense Note (the "Note").

THEREFORE, BE IT RESOLVED, that the Board of Trustees and the Treasurer proceed forthwith to complete said transaction and issue said evidence of indebtedness to cover the same; and

BE IT FURTHER RESOLVED, that said evidence of debt when issued and delivered pursuant to this Resolution shall be a valid and binding general obligation of the Jericho Underhill Water District, payable according to the terms and tenor thereof from unlimited ad valorem taxes duly assessed on the grand list of taxable property in said Jericho Underhill Water District, as established by law; and

BE IT FURTHER RESOLVED, that all acts and things heretofore done by the lawfully constituted officers of the Jericho Underhill Water District and its Board of Trustees in, about, or concerning the expenditure of proceeds of the Note evidencing the borrowing and the issuance thereof are hereby ratified and confirmed; and

We, the undersigned Board of Trustees and Treasurer, hereby certify that we as such officers have signed the Note, numbered 1, dated May 20, 2015 and due May 19, 2016, with an interest rate of 2.20 %, payable as therein set forth and further certify that the Note is issued under and pursuant to this Resolution adopted at a duly noticed and warned meeting of the Board of Trustees of the Jericho Underhill Water District held on Board of Trustees.

We the said Board of Trustees and Treasurer of the Jericho Underhill Water District, hereby certify that we are the duly chosen, qualified and acting officers as undersigned, that the Note is issued pursuant to authority, that no proceeding relating thereto has been taken other than as shown in the foregoing recital, that no such authority or action has been amended or repealed, and that there is no litigation threatened or pending in any state or federal court of competent jurisdiction seeking to enjoin either the issuance of the Note or the expenditures being financed by the proceeds of the same.

 

 

 

We also certify that there has been full and timely compliance with all public procurement, solicitation and bidding laws, ordinances and regulations with respect to each of the transactions embodied in this Resolution

 

We certify also that no litigation is pending or threatened affecting the validity of the Note or the apportionment and assessment of taxes if necessary, to pay the same when due, that neither the corporate existence nor the boundaries of the Board of Trustees, nor the title of any of us to our respective offices is being questioned or contested.

Further, we hereby certify to and covenant with MERCHANTS BANK, its successors and assigns, including specifically the transferees, assigns, holders and owners of the Note that:

  1. The aggregate principal amount of the Note does not exceed the maximum cumulative cash flow deficit of the Jericho Underhill Water District for the term of the Note from date of issue to and including date of maturity, as computed under Sections 148 (f)(4)(iii) of the Internal Revenue Code of 1986, and the Regulations promulgated thereunder.
  2. No proceeds of the Note (including investment proceeds thereof) will be used (directly or indirectly) in any trade or business carried on by any person other than the Jericho Underhill Water District nor used to make or finance loans to any person.
  3. During the current calendar year, the Jericho Underhill Water District will not ssue debt of any sort aggregating $10,000,000.00 or more.
  4. The Jericho Underhill Water District will file when and as required with the Treasury Department or Internal Revenue Service information returns relating to the issuance of the Note and all other obligations of the Jericho Underhill Water District.
  5. The Jericho Underhill Water District will comply with, perform, maintain and keep each and every covenant, representation, certification and undertaking in the accompanying Tax Certificate, execution and delivery of which is hereby authorized.

Jericho Underhill Water District

 

Treasurer

 

 

 

 

 

 

 

 

 

 

 

ATTEST:

 

 

 

Clerk                                                                                      Board of Trustees Or a Majority Thereof

 

Jericho Underhill Water District
TAX CERTIFICATE

CURRENT EXPENSE BORROWING

We the Treasurer and at least a majority of the Board of Trustees of the Jericho Underhill Water District, Vermont (the "Issuer"), hereby certify and represent as follows with respect to the aggregate $75,000.00 Current Expense Note of the Issuer (the "Note"), which Note is dated May 20, 2015 and is payable as therein set forth:

  1. The Issuer is issuing and delivering the Note simultaneously with the delivery of this Certificate.
  2. We are the officers of die Issuer charged by law with the responsibility for issuing the Note.
  3. The Note is being issued for the purpose of paying certain current expenses required by law to be made, which expenditures shall be made in a timely fashion.
  4. The entire amount borrowed by the issuance of the Note, together with all of such, if any, amounts previously raised or borrowed for the same purpose, does not exceed the total costs of such current expenses less all other funds available for the purpose, and all of the proceeds of the Note have been or are expected to be needed and expended for such current expenses within six (6) months from the date of the first borrowing for these expenses.
  5. The Note is not being issued to a refund note previously issued for the same purpose described in paragraph (3).
  6. Any real and personal property, acquisition of which has been financed by the Note has not been and is not expected during the life of the Note to be sold or otherwise disposed of for consideration.
  7. It is expected that any earnings or net profit derived from investment or deposit of the proceeds of the Note, including transferred proceeds, any accrued interest received upon sale of the Note and any premium received on the delivery thereof, will be expended for current expense payment purposes within the period stated in paragraph (4) above to the extent such funds arc not commingled for accounting purposes in the general funds of the Issuer with tax and other substantial operating revenues.
  8. The Issuer has not created and does not expect to create or establish any debt service fund, bond payment reserve, sinking fund, or other similar fund pledged to the payment of the Note or from which it is expected that payment of the Note would be made.
  9. To the best of our knowledge, information and belief, the above expectations are reasonable.
  10. The Issuer has not been notified of any action by the Commissioner of Internal Revenue to disqualify it as an issuer whose arbitrage certificates may be relied upon.
  11. No part of the proceeds derived from the issuance and sale of the Note nor the expenditures financed by the proceeds of the Note shall be:

 

 

  1. Used, loaned or otherwise made available to any person or other entity, other than the Issuer or a governmental body, so as to cause the Note to be classified as a private activity bond or [a] an arbitrage bond, as those terms are defined under the Internal Revenue Code of 1986, as amended, and the Regulations promulgated thereunder by the U. S. Treasury (collectively, the "Code").
  2. Used directly or indirectly in a trade or business by any person other than the Issuer or another municipal entity;
  3. Loaned to any person directly or indirectly other than the Issuer;
  4. The subject of any contract, lease or agreement of any sort having a term of one year or more and calling for the payment by the Issuer of consideration other than a flat fee;
  5. Expended to finance the construction, alteration or renovation of any improvement the use, occupancy, availability or beneficial enjoyment of which shall be restricted among public users thereof or for which preferential, different or unique fees, rates, assessments or charges shall be levied;
  6. Invested in such a manner or for such a period or at a yield to result in the rebate of interest earnings thereon to the United States under any public law now or hereafter in effect;
  1. The Issuer shall furnish to the United States, or any agency, department or instrumentality thereof, in a timely fashion, such information as may be required by law with respect to all evidences or debt now or hereafter issued by the Issuer.
  2. Neither the proceeds of the Note, nor any earnings derived from the investment thereof, shall be expended for the purpose of paying any costs associated with the issuance of the Note.
  3. The Note will not be refunded or otherwise paid, defeased or secured by the proceeds of any form of debt issued by the Issuer, if the manner of such payment, refunding or security, results in the Note being classified as a "private activity bond" or an "arbitrage bond" within the meaning of Sections 103, 141 and 148 of the Code.
  4. The proceeds of the Note shall not be invested for a period or at a yield so as to render the interest payable on the Note includable in the gross income of the holder thereof.
  5. The proceeds of the Note will not be used in a manner that will cause the Note to be "arbitrage bonds" or "private activity bonds" within the meaning of Sections 103(c), 141 and 148 of the Code.
  6. The aggregate principal amount of the Note is not greater than the maximum anticipated cumulative cash flow deficit which has been computed in accordance with the Regulations promulgated under Section 148 of the Code.
  7. The Note is declared to be a "qualified" obligation under Section 265(b) of the Code.

This Certificate is executed and is being delivered pursuant to Section 1.148(b)(2)( ) of the Regulations promulgated under Section 148 of the Code.

 

 

 

Dated May 20, 2015                                                          Jericho Underhill Water District

 

Treasurer                                                                             Board of Trustees or a Majority Thereof

Form 8038-GC

(Rev. January 2012)

Department of the Treasury Internal Revenue Service

 

Information Return for Small Tax-Exempt
Governmental Bond Issues, Leases, and Installment Sales

 

OMB No. 1545-0720

Ist- Under Internal Revenue Code section 149(e)

 

Caution: If the issue price of the issue is $100,000 or more, use Form 8038-G.

 

 

8a

00

75,000

9a

9b

9c

9d

9e

9f

9g

9h

9i

9j

 

Reporting

Authority

Check box if Amended Return 10                                                               

-

1   Issuer's name

Jericho Underhill Water District

2  Issuer's employer identification number (EIN)

0      3 I 0       2      9      1    6    1       0

3   Number and street (or P.O. box if mail is not delivered to street address)
PO Box 174

Roonvsuite

City, town, or post office, state, and ZIP code
Underhill, VT 05489

5

 

Reportumber

(For

IRS Use Only)

6  Name and title of officer or other employee of issuer or designated contact person whom the IRS may call for more information

Jane Mahjeux

7  Telephone number of

802-899-3810

officer or legal representative

                 

Part      Description of Obligations Check one: a single issue 0 or a consolidated return

8a Issue price of obligation(s) (see instructions)

b Issue date (single issue) or calendar date (consolidated). Enter date in mm/dd/yyyy format (for

example, 01/01/2009) (see instructions) II*     5/2012015  

9        Amount of the reported obligation(s) on line 8a that is:

For leases for vehicles

For leases for office equipment........................................................................................................................

For leases for real property .............................................................................................................................  

For leases for other (see instructions) ............................................................................................................  

e For bank loans for vehicles .............................................................................................................................  

f    For bank loans for office equipment ..............................................................................................................  

For bank loans for real property......................................................................................................................

For bank loans for other (see instructions) ......................................................................................................  

i    Used to refund prior issue(s)

j    Representing a loan from the proceeds of another tax-exempt obligation (for example, bond bank)

Other .................................................................................................................................................................. 9k                       75,000 00

10      If the issuer has designated any issue under section 265(b)(3)(B)(i)(111) (small issuer exception), check his box . .                        . 10-

11      If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check this box (see instructions) ...........................................  

12 Vendor's or bank's name: Merchants Bank

13      Vendor's or bank's employer identification number:                 0            3 ;         0             1            4            1           2             3           0

Signature and

Consent

Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that I consent to the IRS's disclosure of the issuer's return information, as necessary to process this return, to the percents) that I have authorized above.

Jane Maheux

Signature of issuer's authorized representative                            Date                                 Type or print name and title

Paid Preparer Use Only

Print/Type preparer's name

Preparer's signature

Date

Check ID if self-employed

PTIN

Firm's name  S.

Firm's EIN to-

Firm's address le

Phone no.

             

 

General Instructions

Section references are to the Internal Revenue Code unless otherwise noted,

What's New

The IRS has created a page on IRS.gov for information about the Form 8038 series and its instructions, at www.irs.gov/form8038Information about any future developments affecting the Form 8038 series (such as legislation enacted after we release it) will be posted on that page.

Purpose of Form

Form 8038-GC is used by the issuers of tax-exempt governmental obligations to provide the IRS with the information required by section 149(e) and to monitor the

requirements of sections 141 through 150.

Who Must File

Issuers of tax-exempt governmental obligations with issue prices of less than $100,000 must file Form 8038-GC.

Issuers of a tax-exempt governmental obligation with an issue price of $100,000 or more must file Form 8038-G, Information Return for Tax-Exempt Governmental Obligations.

Filing a separate return for a single issue. Issuers have the option to file a separate Form 8038-GC for any tax-exempt governmental obligation with an issue price of less than $100,000.

An issuer of a tax-exempt bond used to finance construction expenditures must file a separate Form 8038-GC for each issue to give notice to the IRS that an election was made to

pay a penalty in lieu of arbitrage rebate (see the line 11 instructions).

Filing a consolidated return for multiple issues. For all tax-exempt governmental obligations with issue prices of less than $100,000 that are not reported on a separate Form 8038-GC, an issuer must file a consolidated information return including all such issues issued within the calendar year.

Thus, an issuer may file a separate Form 8038-GC for each of a number of small issues and report the remainder of small issues issued during the calendar year on one consolidated Form 8038-GC. However, if the issue is a construction issue, a separate Form 8038-GC must be filed to give the IRS notice of the election to pay a penalty in lieu of arbitrage rebate.

 

 

Sat. No. 641088

Form 8038-GC (Rev. 1-2012)

Form 8038-GC (Rev. 1-2012)                                                                                                                                                                           Page 2

 

When To File

To file a separate return for a single issue, file Form 8038-GC on or before the 15th day of the second calendar month after the close of the calendar quarter in which the issue is issued.

To file a consolidated return for multiple issues, file Form 8038-GC on or before February 15th of the calendar year following the year in which the issue is issued.

Late filing. An issuer may be granted an extension of time to file Form 8038-GC under section 3 of Rev. Proc. 2002-48, 2002-37 I.R.B. 531, if it is determined that the failure to file on time is not due to willful neglect. Type or print at the top of the form, "Request for Relief under section 3 of Rev. Proc. 2002-48." Attach to the Form 8038-GC a letter briefly stating why the form was not submitted to the IRS on time. Also indicate whether the obligation in question is under examination by the IRS. Do not submit copies of any bond documents, leases, or installment sale documents. See Where To File next.

Where To File

File Form 8038-GC, and any attachments, with the Department of the Treasury, Internal Revenue Service Center, Ogden, UT 84201.

Private delivery services. You can use certain private delivery services designated by the IRS to meet the "timely mailing as timely filing/paying" rule for tax returns and payments. These private delivery services include only the following:

  • DHL Express (DHL): DHL Same Day Service.
  • Federal Express (FedEx): FedEx Priority Overnight, FedEx Standard Overnight, FedEx 2Day, FedEx International Priority, and FedEx International First.
  • United Parcel Service (UPS): UPS Next Day Air, UPS Next Day Air Saver, UPS 2nd Day Air, UPS 2nd Day Air A.M., UPS Worldwide Express Plus, and UPS Worldwide Express.

The private delivery service can tell you how to get written proof of the mailing date.

Other Forms That May Be
Required

For rebating arbitrage (or paying a penalty in lieu of arbitrage rebate) to the Federal Govemment, use Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate. For private activity bonds, use Form 8038, Information Return for Tax-Exempt Private Activity Bond Issues.

For a tax-exempt governmental obligation with an issue price of $100,000 or more, use Form 8038-G.

Rounding to Whole Dollars

You may show the money items on this return as whole-dollar amounts. To do so, drop any amount less than 50 cents and increase any amount from 50 to 99 cents to the next higher dollar.

Definitions

Obligations. This refers to a single tax-exempt govemmental obligation if Form 8038-GC is used for separate reporting or to multiple tax-exempt governmental obligations if the form is used for consolidated reporting.

Tax-exempt obligation. This is any obligation including a bond, installment purchase agreement, or financial lease, on which the interest is excluded from income under section 103.

Tax-exempt governmental obligation. A tax-exempt obligation that is not a private activity bond (see below) is a tax-exempt governmental obligation. This includes a bond issued by a qualified volunteer fire department under section 150(e).

Private activity bond. This includes an obligation issued as part of an issue in which:

  • More than 10% of the proceeds are to be used for any private activity business use, and
  • More than 10% of the payment of principal or interest of the issue is either (a) secured by an interest in property to be used for a private business use (or payments for such property) or (b) to be derived from payments for property (or borrowed money) used for a private business use.

It also includes a bond, the proceeds of which (a) are to be used to make or finance loans (other than loans described in section 141(c)(2)) to persons other than governmental units and (b) exceeds the lesser of 5% of the proceeds or $5 million.

Issue. Generally, obligations are treated as part of the same issue only if they are issued by the same issuer, on the same date, and as part of a single transaction, or a series of related transactions. However, obligations issued during the same calendar year (a) under a loan agreement under which amounts are to be advanced periodically (a "draw-down loan") or (b) with a term not exceeding 270 days, may be treated as part of the same issue if the obligations are equally and ratably secured under a single indenture or loan agreement and are issued under a common financing arrangement (for example, under the same official statement periodically updated to reflect changing factual circumstances). Also, for obligations issued under a draw-down loan that meets the requirements of the preceding sentence, obligations issued during different calendar years may be treated as part of the same issue if all of the amounts to be advanced under the draw-down loan are reasonably expected to be advanced within 3 years of the date of issue of the first obligation. Likewise, obligations (other than private activity bonds) issued under a single agreement that is in the form of a lease or installment sale may be treated as part of the same issue if all of the property covered by that agreement is reasonably expected to be delivered within 3 years of the date of issue of the first obligation.

Arbitrage rebate. Generally, interest on a state or local bond is not tax-exempt unless the issuer of the bond rebates to the United States arbitrage profits earned from investing proceeds of the bond in higher yielding nonpurpose investments. See section 148(f).

Construction issue. This is an issue of tax-exempt bonds that meets both of the following conditions:At least 75% of the available construction proceeds of the issue are to be used for construction expenditures with respect to property to be owned by a governmental unit or a 501(c)(3) organization, and

  1. All of the bonds that are part of the issue are qualified 501(c)(3) bonds, bonds that are not private activity bonds, or private activity bonds issued to finance property to be owned by a governmental unit or a 501(c)(3) organization.

In lieu of rebating any arbitrage that may be owed to the United States, the issuer of a construction issue may make an irrevocable election to pay a penalty. The penalty is equal to 1-1/2% of the amount of construction proceeds that do not meet certain spending requirements. See section 148(f)(4)(C) and the Instructions for Form 8038-T.

Specific Instructions

In general, a Form 8038-GC must be completed on the basis of available information and reasonable expectations as of the date of issue. However, forms that are filed on a consolidated basis may be completed on the basis of information readily available to the issuer at the close of the calendar year to which the form relates, supplemented by estimates made in good faith.

Part I—Reporting Authority

Amended return. An issuer may file an amended retum to change or add to the information reported on a previously filed return for the same date of issue. If you are filing to correct errors or change a previously filed return, check the "Amended Return" box in the heading of the form.

The amended return must provide all the information reported on the original return, in addition to the new corrected information. Attach an explanation of the reason for the amended return and write across the top "Amended Return Explanation."

Line 1. The issuer's name is the name of the entity issuing the obligations, not the name of the entity receiving the benefit of the financing. In the case of a lease or installment sale, the issuer is the lessee or purchaser.

Line 2. An issuer that does not have an employer identification number (EIN) should apply for one on Form SS-4, Application for Employer Identification Number. You can get this form on the IRS website at IRS.gov or by calling 1-800-TAX-FORM (1-800-829-3676). You may receive an EIN by telephone by following the instructions for Form SS-4.

Lines 3 and 4. Enter the issuer's address or the address of the designated contact person listed on line 6. If the issuer wishes to use its own address and the issuer receives its mail in care of a third party authorized representative (such as an accountant or attorney), enter on the street address line "0/0" followed by the third party's name and street address or P.O. box. Include the suite, room, or other unit number after the street address. If the post office does not deliver mail to the street address and the issuer has a P.O. box, show the box number instead of the

 

Form 8038-GC (Rev. 1-2012)                                                                                                                                                                           Page 3

street address. If a change in address occurs after the return is filed, use Form 8822, Change of Address, to notify the IRS of the new address.

Note. The address entered on lines 3 and 4 is the address the IRS will use for all written communications regarding the processing of this return, including any notices. By authorizing a person other than an authorized officer or other employee of the issuer to communicate with the IRS and whom the IRS may contact about this return, the issuer authorizes the IRS to communicate directly with the individual listed on line 6, whose address is entered on lines 3 and 4 and consents to disclose the issuer's return information to that individual, as necessary, to process this return.

Line S. This line is for IRS use only. Do not make any entries in this box.

Part II—Description of Obligations

Check the appropriate box designating this as a return on a single issue basis or a consolidated return basis.

Line 8a. The issue price of obligations is generally determined under Regulations section 1.148-1(b). Thus, when issued for cash, the issue price is the price at which a substantial amount of the obligations are sold to the public. To determine the issue price of an obligation issued for property, see sections 1273 and 1274 and the related regulations.

Line 8b. For a single issue, enter the date of issue (for example, 03/15/2010 for a single issue issued on March 15, 2010), generally the date on which the issuer physically exchanges the bonds that are part of the issue for the underwriter's (or other purchaser's) funds; for a lease or installment sale, enter the date interest starts to accrue. For issues reported on a consolidated basis, enter the first day of the calendar year during which the obligations were issued (for example, for calendar year 2010, enter 01/01/2010).

Lines 9a through 9h. Complete this section if property other than cash is exchanged for the obligation, for example, acquiring a police car, a fire truck, or telephone equipment through a series of monthly payments. (This type of obligation is sometimes referred to as a "municipal lease.") Also complete this section if real property is directly acquired in exchange for an obligation to make periodic payments of interest and principal.

Do not complete lines 9a through 9d if the proceeds of an obligation are received in the form of cash even if the term "lease" is used in the title of the issue. For lines 9a through 9d, enter the amount on the appropriate line that represents a lease or installment purchase. For line 9d, enter the type of item that is leased. For lines 9e through 9h, enter the amount on the appropriate line that represents a bank loan. For line 9h, enter the type of bank loan. Lines 9i and 9j. For line 9i, enter the amount of the proceeds that will be used to pay principal, interest, or call premium on any other issue of bonds, including proceeds that will be used to fund an escrow account for this purpose. Several lines may apply to a particular obligation. For example, report on lines 9i and 9j obligations used to refund prior issues which represent loans from the proceeds of another tax-exempt obligation.

Line 9k. Enter on line 9k the amount on line 8a that does not represent an obligation described on lines 9a through 9j.

Line 10. Check this box if the issuer has designated any issue as a "small issuer exception" under section 265(b)(3)(B)(0(111).

Line 11. Check this box if the issue is a construction issue and an irrevocable election to pay a penalty in lieu of arbitrage rebate has been made on or before the date the bonds were issued. The penalty is payable with a Form 8038-T for each 6-month period after the date the bonds are issued. Do not make any payment of penalty in lieu of rebate with Form 8038-GC. See Rev. Proc. 92-22, 1992-1 C.B. 736, for rules regarding the "election document."

Line 12. Enter the name of the vendor or bank who is a party to the installment purchase agreement, loan, or financial lease. If there are multiple vendors or banks, the issuer should attach a schedule.

Line 13. Enter the employer identification number of the vendor or bank who is a party to the installment purchase agreement, loan, or financial lease. If there are multiple vendors or banks, the issuer should attach a schedule.

Signature and Consent

An authorized representative of the issuer must sign Form 8038-GC and any applicable certification. Also print the name and title of the person signing Form 8038-GC. The authorized representative of the issuer signing this form must have the authority to consent to the disclosure of the issuer's return information, as necessary to process this return, to the person(s) that has been designated in this form.

Note. If the issuer authorizes in line 6 the IRS to communicate with a person other than an officer or other employee of the issuer, (such authorization shall include contact both in writing regardless of the address entered in lines 3 and 4, and by telephone) by signing this form, the issuers authorized representative consents to the disclosure of the issuer's retum information, as necessary to process this return, to such person.

Paid Preparer

If an authorized representative of the issuer filled in its return, the paid preparer's space should remain blank. Anyone who prepares the return but does not charge the organization should not sign the return. Certain others who prepare the return should not sign. For example, a regular, full-time employee of the issuer, such as a clerk, secretary, etc., should not sign.

Generally, anyone who is paid to prepare a return must sign it and fill in the other blanks in the Paid Preparer Use Only area of the return. A paid preparer cannot use a social security number in the Paid Preparer Use Only box. The paid preparer must use a preparer tax identification number (PTIN). If the paid preparer is self-employed, the preparer should enter his or her address in the box.

The paid preparer must:

  • Sign the return in the space provided for the preparer's signature, and
  • Give a copy of the return to the issuer.

Paperwork Reduction Act Notice

We ask for the information on this form to carry out the Internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103.

The time needed to complete and file this form will vary depending on individual circumstances. The estimated average time is:

Learning about the

law or the form     .               . . 4 hr., 46 min.

Preparing the form .            . . 2 hr., 22 min.

Copying, assembling, and

sending the form to the IRS . 2 hr., 34 min.

If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordinating Committee, SE:W:CAR:MP:T:M:S, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not send the form to this address. Instead, see Where To File.