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Tax FormForm 8038-G Information Return for Tax -Exempt Governmental Obligations ► Under Internal Revenue Code section 149(e) OMB No. 1545-0720 (Rev. May 1999) ► see separate Instructions. oeparunent of the Treasury Caution: Use Form 8038 -GC if the issue price is under $100,000. Internal Revenue Service ff MWIF1111 Rpnnrtinn Authnritv If Amended Return. check here ► 1-1 1 Issuer's name of Salina. Kansas 2 Issuer's employer identification number 48 :6 17228 —City 3 Number and street for P.O. box if mail is not delivered to street address) P.O. Box 736 Room/suite 4 Re number -1-A Proceeds used for bond issuance costs (including underwriters' discount) 24 25 G2000 5 City, town, or post office, state, and ZIP code Proceeds allocated to reasonably required reserve or replacement fund . 6 Date of issue 27 Salina, KS 67402-0736 27 --- 11/8/1999 7 Name of issue 29 8 CUSIP number . . . . 29 --- Lease -Purchase EDP Equipment NA 9 Name and title of officer or legal representative whom the IRS may call for more information 10 Telephone runt er of officer or legal representative Rodney Franz Director of Finance 1 (785 )826-7240 rsffm)l Type of Issue (cnecK applicable Dox(es) ana enter the Issue price) See instructions and attacn scnedule 11 ❑ Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 ❑ Health and hospital . . . . . . . . . . . . . . . . . . . . . . 12 13 ❑ Transportation . . . . . . . . . . . . . . . . . . . . . . . . . _ 13 14 ❑ Public safety . . . . . . . . . . . . . . . . . . . . . . . . . _ 14 15 ❑ Environment (including sewage bonds) . . . . . . . . . . . . . . . . . . . 15 16 ❑Housing . 16 17 ❑ Utilities . . . _ 17 18 Q Other. Describe ► General ' GOy@rilmerit ' 1g ,bg 19 If obligations are TANS or RANs, check box ► ❑ If obligations are BANS, check box ► ❑ 20 If obligations are in the form of a lease or installment sale, check box . ► 0 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 i/n1 /9nn9 $ 9A1 _5R7 $ NA I i years 5 22 Proceeds used for accrued interest . . . . . . . . . . . . . . . . . . 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 . . . . . . . . . . . J22 _ 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 --- �]I 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 . . . . . . . . . . . ► 34 Enter the date(s) the refunded bonds were issued Ill - 35 35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) _ so --- 36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see instructions) I36a --- b Enter the final maturity date of the guaranteed investment contract ► 37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units 37a --- 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 110- 38 38 If the issuer has designated the issue under section 265(b)(3)(13)(i)(III) (small issuer exception), check box ► ❑ 39 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . . . . . . . . . . . No. ❑ 40 If the issuer has identified a hedge, check box . 0'.0 Under penalties of perjury, I are that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief_ they are tWe, correct, and complete. Please Sign /�V_& -11" 1/25, ,Here ign a issuer's auth'q1tized reprWKtative Date For Paperwork Reduction Act see page z of the Instructions. QD 2000 , Rodney Franz, Director of Finance Type or print name and title Cat. No. 63773S Form 8038-G (Rev. 5-99) Instructions for Form 8038-G (Revised May 1999) Information Return for Tax -Exempt Governmental Obligations (Caution: Use Form 8038 -GC if the issue price is less than $100,000.) Section references are to the Internal Revenue Code, unless otherwise noted. General Instructions Purpose of Form Form 8038-G is used by 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. Complete Parts II through VI on the basis of available information and reasonable expectations as of the date the issue is issued. If an item does not apply to the issue you are reporting, write "N/A" in the space provided for the item. Who Must File IF the issue price THEN, for tax-exempt (line 21, column (b)) governmental obligations is... Issued after December 31, 1986, Issuers must file... $100,000 or more A separate Form 8038-G for each issue Less than $100,000 Form 8038 -GC, Information Return for Small Tax -Exempt Governmental Bond Issues, Leases, and Installment Sales Other Forms That May Be Required For rebating arbitrage (or paying a penalty in lieu of arbitrage rebate) to the Federal government, use Form 8038-T, Arbitrage Rebate and Penalty in Lieu of Arbitrage Rebate. For private activity bonds, use Form 8038, Information Return for Tax -Exempt Private Activity Bond Issues. When To File File Form 8038-G on or before the 15th day of the 2nd calendar month after the close of the calendar quarter in which the issue is issued. Complete Form 8038-G based on the facts as of the issue date. Late filing. An issuer may be granted an extension of time to file Form 8038-G under Section 3 of Rev. Proc. 88-10, 1988-1 C.B. 635, if it is determined that the failure to file on time is not due to willful neglect. Enter at the top of the form "This Statement Is Submitted in Accordance with Rev. Proc. 88-10." Attach to the Form 8038-G a letter explaining why Form 8038-G was not submitted to the IRS on time. Also indicate whether the bond issue in question is under examination by the IRS. Do not submit copies of the trust indenture or other Internal bond documents. Where To File File Form 8038-G with the Internal Revenue Service Center, Ogden, UT 84 0� Rounding to Whole Dollars You may show amounts on this return as whole dollars. To do so, drop amounts less than 50 cents and increase amounts from 50 cents through 99 cents to the next higher dollar. Definitions 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: e More than 10% of the proceeds are to be used for any private activity business use, and e 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 are to be used to make or finance loans (other than loans described in section 141(c)(2)) to certain persons exceeds the smaller of 5% of the proceeds or $5 million. Issue price. 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. 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 (e.g., 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 Cat. No. 63774D raDepartment of the Treasury Internal Revenue Service 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: 1. At least 75% of the available construction proceeds 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 2. All 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 1112% 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 Part I—Reporting Authority Amended Return. If you are filing an amended Form 8038-G, check the amended return box and complete Part I and only those parts of Form 8038-G you are amending. Use the same report number (line 4) as was used for the original report. Do not amend the estimated amounts previously reported once the actual amounts are determined. 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. For a lease or installment sale, the issuer is the lessee or the 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. This form may be obtained at Social Security Administration offices or by calling 1 -800 -TAX -FORM. If the EIN has not been received by the due date for Form 8038-G, write "Applied for" in the space for the EIN. Line 4. Number reports consecutively based on the filing date (not the date of issue). For example, if the issuer filed two Forms 8038-G in the 1999 calendar year, the "report number" for the third Form 8038-G would be "G1999-3." If an issuer (e.g., a state) issues obligations through many departments or agencies, the issuer may assign a letter of the alphabet to each department or agency, and each may separately number its reports by indicating both the report number and letter (e.g., G1999 -5-C, G1999 -2-D). Line 6. The date of issue is 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. Line 7. If there is no name of the issue, please provide other identification of the issue. Line 8. Enter the CUSIP (Committee of Uniform Securities Identification Procedure) number of the bond with the latest maturity. If the issue does not have a CUSIP number, write "None." Part 11—Type of Issue Identify the type of obligations issued by checking the appropriate box(es) and entering the corresponding issue price (see Issue price under Definitions on page 1). Attach a schedule listing names and EINs of organizations that are to use proceeds of these obligations if different from those of the issuer. Line 18. Check the box on this line only if lines 11 through 17 do not apply. Enter a description of the issue in the space provided. Line 19. If the obligations are short-term tax anticipation notes or warrants (TANS) or short-term revenue anticipation notes or warrants (RANs), check the first box on this line. If the obligations are short-term bond anticipation notes (BANs), issued with the expectation that they will be refunded with the proceeds of long-term bonds at some future date, check the second box on this line. Line 20. Check this box if property other than cash is exchanged for the obligation, e.g., 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 check this box if real property is directly acquired in exchange for an obligation to make periodic payments of interest and principal. Do not check this box if the proceeds of the obligation are received in the form of cash, even if the term "lease" is used in the title of the issue. Part III—Description of Obligations Line 21 For column (b), see Issue price under Definitions on page 1. Page 2 For column (c), the stated redemption price at maturity of the entire issue is the sum of the stated redemption prices at maturity of each bond issued as part of the issue. For a lease or installment sale, write "N/A." For column (d), the weighted average maturity is the sum of the products of the issue price of each maturity and the number of years to maturity (determined separately for each maturity and by taking into account mandatory redemptions), divided by the issue price of the entire issue (from line 21, column (b)). For a lease or installment sale, enter instead the total number of years the lease or installment sale will be outstanding. For column (e), the yield, as defined in section 148(h), is the discount rate that, when used to compute the present value of all payments of principal and interest to be paid on the obligation, produces an amount equal to the purchase price, including accrued interest. See Regulations section 1.148-4 for specific rules to compute the yield on an issue. If the issue is a variable rate issue, write "VR" as the yield of the issue. For other than variable rate issues, carry the yield out to four decimal places (e.g., 5.3125%). If the issue is a lease or installment sale, enter the effective rate of interest being paid. Part IV—Uses of Proceeds of Bond Issue For a lease or installment sale, write "N/A" on Part IV. Line 22. Enter the amount of proceeds that will be used to pay interest from the date the bonds are dated to the date of issue. Line 24. Enter the amount of the proceeds that will be used to pay bond issuance costs, including fees for trustees and bond counsel. Line 25. Enter the amount of the proceeds that will be used to pay fees for credit enhancement that are taken into account in determining the yield on the issue for purposes of section 148(h) (e.g., bond insurance premiums and certain fees for letters of credit). Line 27. Enter the amount of the proceeds that will be used to pay principal, interest, or call premium on any other issue of bonds within 90 days of the date of issue. Line 28. Enter the amount of the proceeds that will be used to pay principal, interest, or call premium on any other issue of bonds after 90 days of the date of issue, including proceeds that will be used to fund an escrow account for this purpose. Part V—Description of Refunded Bonds Complete this part only if the bonds are to be used to refund a prior issue of tax-exempt bonds. For a lease or installment sale, write "N/A" on Part V. Lines 31 and 32. The remaining weighted average maturity is determined without regard to the refunding. The weighted average maturity is determined in the same manner as on line 21, column (d). Line 34. If more than a single issue of bonds will be refunded, enter the date of issue of each issue. Part VI—(Miscellaneous Line 36. If any portion of the gross proceeds of the issue are or will be invested in a guaranteed investment contract, as defined in Regulations section 1.148-1(b), enter the amount of the gross proceeds so invested, as well as the final maturity date of the guaranteed investment contract. Line 37a. Enter the amount of this issue used to fund a loan to another governmental unit, the interest of which is tax-exempt. Line 39. 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 arbitrage rebate with this form. See Rev. Proc. 92-22, 1992-1 C.B. 736 for rules regarding the "election document." Line 40. Check this box if the issuer identified a hedge on its books and records in accordance with Regulations sections 1.148-4(h)(2)(viii) and 1.148-4(h)(5). These regulations permit an issuer of tax-exempt bonds to identify a hedge for it to be included in yield calculations for computing arbitrage. 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 varies depending on individual circumstances. The estimated average time is: Learning about the law or the form. 2 hr., 41 min. Preparing, copying, assembling, and sending the forth to the IRS...... 3 hr., 3 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 Tax Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. DO NOT send the form to this office. Instead, see Where To File on page 1.