8038-GB I6 -221 -1000
FA%: O I6 -221 -1010
WWW.GILMORESELL.COM
Mr. Rod Franz
Finance Director
City of Salina
300 W. Ash St.
Salina, Kansas 67402 -1736
Re: $3,400,000 General
Kansas
Dear Rod:
GILMORE & BELL
A PROFESSIONAL CORPORATION
ATTORNEYS AT LAW
2405 GRAND BOULEVARD, SUITE 1100
KANSAS CITY, MISSOURI 64108-2521
July 27, 2011
Obligation (Temporary
ST. LOUIS, MISSOURI
WICHITA, KANSAS
LINCOLN, NEBRASKA
VIA E -MAIL
rod. franzna safina.my
Notes, Series 2011 -1 of the City of Salina,
Enclosed is a completed Internal Revenue Service ( "IRS ") Form 8038 -G (Information Return for
Tax- Exempt Governmental Obligations). An!� "Issuer Copy" is also included for your records. A
completed copy of the return and evidence of filmg will be included in the Note Transcript.
Please sign the Form 8038 -G and return 'i t via overnight delivery so that it may be filed as soon as
possible following the closing.
When the form is processed by the IRS, a Notice CP152 will be sent to you to acknowledge
receipt of the form. This official acknowledgement should be retained for reference in case future
correspondence with the IRS concerning this issue is required. In addition, please send a copy of the
notice to us for our file.
If you have any questions, please call me'l,
Very truly yobs,
Gina M. elchof
GNM::jac
Enclosure
80(r Information Return for Tax - Exempt Governmental Obligations
Porm v vu 3Q. aa�s I ► Under Internal Revenue Coda section 149(e) I OMB No. 1545 -0720
(Rev. May 2010) ► See separate Instructions.
oeparbn evmerw Teaemry Caution: If the issue price is under $100, 000, use Form 8038 -GC.
Internal Revenue T.
Reporting Author
If Amended .Retum, check here ► LJ
1 Issuers rune
2 Issuer's employer Mentlficafon number (FIM
City of Salina, Kansas
48 6017288
3 Number and street (or P.O. box it mail Is not delivered to street address)
Roomfsui[e
4 Report number (For IRS Use On /y)
300 W. Ash Street
-
3
5 City, town, or post office, state, and ZIP code
6 Date of issue
Salina, Kansas 67402 -1736 -
07/2812011
7 Name of Issue General Obligation Temporary Notes, Series 2011 -1
8 CUSIP number
Transportation . . . . . . . .. . . . . .
794743 Y73 -
9 Nacre and title of officer of the issuer or other person whom the IRS may call for more Wonnation
10 Telephone number of officer or other person
Gina Rlekhof, Bond Counsel, Gilmore 8: Bell, P.C.
( 816 ) 221 -1000
tf•IIillll 1 viae oT Issue levier the issue pnCet bee Instructions and attach schedule
11
Education . . . . . . . . . .. . . . . '..
. . . . . . .
. .
11
22
491
12
23
3,400,000
12
Health and hospital . . . . . . . . . .
24
_
13
12,399
00
13
Transportation . . . . . . . .. . . . . .
. . . . . . . . . . .
. . .
14
25
0
14
Public safety . . . . . . .
. ..
15
Proceeds allocated to reasonably required reserve or replacement fund .
26 -
15
Environment (including sewage bonds) . .. . . ...
. . . . . . . . . .. .
.
16 -
27
Proceeds used to currently refund prior issues . . . .
16
Housing.. .. . . . . . . . . .. .
. . . . .
-°
17
28
17
Utilities - . .
. . . . . . .
00
18
3,400,000
00
18 Other. Describe ► Various Internal Improvements
19
If obligations are TANS or FANS, check only box 19a
If obligations are BANS, check only box 19b
. . . . . . . . . . .
. . . . . . . ... . .
► ❑
. ► ❑
29
d'°
00
;70
atIn. the,jo�rm of aleas��alirner�l ., check box
x_
► (�
mt horal
zn
z za7 ant
'De " -' ton a,`Obll ion',,, let@f_gr
,`•entire ;issue to wtyTch
thisf Xrrt ilS bein
filed,,,. t'
++.
(a).Fl..• mY date'
�.r'•• ?
ibt lssge Pnce r °'...
'y (c) Stated r§�mpaon
>; (d) w
more
fA1Cd`
ma __.S.
.
(YeW
f'!:
21
08/01l20�
$"" " ��` 6 , 0. b
'$
3,40 M0.00
"ears
` 0.3861 %
Uses of Proceeds of Bond Issue (including underwriters' discount
-
22
Proceeds used for accrued interest . . . . . . . . . . . . .
. . .
. .
22
491
11
23
3,400,000
00
23 Issue price of entire issue (enter amount from line 21, column (b)) .
24
Proceeds used for bond issuance costs (including underwriters' discount)
24
12,399
00
-
25
Proceeds used for credit enhancement
25
0
00
26
Proceeds allocated to reasonably required reserve or replacement fund .
26 -
0
00
'
-
27
Proceeds used to currently refund prior issues . . . .
27
0
00
-°
28
... . . .
Proceeds used to advance refund prior issues . ... . . . . . .
0
00
29
Total (add lines 24 through 28) . . .
. .
29
12,399
00
30
Nonrefundino proceeds of the issue (subtract line 99 frnm line 73 and nntnr
amn,
mt horal
zn
z za7 ant
nn
31 Enter the remaining weighted average maturity of the bonds to be currently refunded. . . ► - yew
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) . . . . . I -
34. Enter the dates) the refunded bonds were issued ► (Mnmoomw)
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat- No. 63773S Forrn 8038 -G (Rev. 5 -2010)
Form 8038 -G
2
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) .
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
(GIC) (see instructions) . . . . . . . . . . . . . . . . . . . . . `36a
b Enter the final maturity date of the GIC ► "s
37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other
R
governmental units . . . . . .. . . . . .. . . . . . . . . . . . 378
b If this issue is a loan made from the proceeds of another tax- exempt issue, -check box ► ❑ and enter the name of the
issuer ► and the date of the issue ►
38 If the issuer has designated the issue under section 265(b)(3)(B)()911) (small issuer exception), check box . . . . ► ❑
39 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . . . . . . . . ► ❑
40 If the issuer has identified a hedge, check box . . . . . . . .. . . . . . . . . . . . . . ► ❑
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 k..Ldg.
and belief, they are true, cosec; and complete. I further declare that I consentto the IRS's disclosure of the issuer's return information, as necessary
W process this return, to the person that I have authorised above.
Signature of issuer's authorized representative Date
Type or print name and Me
Paid
Preparer's
signature
-
Check if
Pre parar's SSN or PTIN
Preparer's
�. t 9 >.� I(
self- employod ❑
PO I z I S Z f E
Use Only
Firms name for
you if off ploy dl
Gilmore & Bell, P.C.
ew 43
1611738
address, and ZIP node _.
2405 Grand Blvd., Suite 1100, Kansas City, MO 64108
Phone an.
f Rte 1 221 -1 nnn
Form 8038 -G' (Rev. 5 -2010)
16ky r rF L �.`G , r ♦ Y. v i 5V
MW