Tab_103Form 8O38G I Information Return for Tax-Exempt Governmental Obligations I
(Rev. September 2011) I Under Internal Revenue Code section 149(e) OMB No. 1545-0720
Department of the Treasury
See separate instructions.
Internal Revenue Service Caution, If the issue price is under $100,000, use Form 8038-GC. I
Rfannrtinre £,IthArih, If Amended Return. eher.k here
1 issuers name 2 Issuers employer. identification number )EIN)
City and Borough of Juneau, Alaska 92-0038816
3e 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 ta
4 Number and street (or P.O. box If mail is not delivered to street address) Room/suite 5 Report number (For IRS Use Only)
155 Steward Street
6 City, town, or post office, state, and ZIP code 7 Date of issue
Juneau, Alaska 99801 11103/2016
8 Name of issue 9 CUSIP number
General Obligation Bond, 2016 and General Obligation School Refunding Bond, 2016 None
IDa Name and title of officer or other employee of the Issuer whom the IRS may call for more information (see lOb Telephone number of officer or other
Instructions) employee shown on 1 O
Robert Bartholomew, Finance Director 907-586-5215
MTi1lI Type of Issue enter the issue price). See the instructions and attach schedule.
11
12
13
14
15
16
17
18
19
20
Education --------------------------------11
Health and hospital .............................12
Transportation .............................13
Public safety .............................._i_
Environment (including sewage bonds) .....................15
Housing ...............................16
Utilities
Other. Describe '-
If obligations are TANS or RANs, check only box 19a .............-
If obligations are BANS, check only box 1 9b ................ 0
If obligations are in the form of a lease or installment sale, check box .........0
18,841,115
3,016,919
1 7
18
ThIHI 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
price at matury average maturity (e) Yield
I
21 12101/2026 I 21,858,034I $ 20,210,0001 36152 years 2.5985 %
IZT11I Uses of Proceeds of Bond Issue (including underwriters' discount)
-
22 0
-
21,858,034
-
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) - 97182
25
26 Proceeds allocated to reasonably required reserve or replacement fund 0
27
Proceeds used for credit enhancement ...............0
Proceeds used to currently refund prior issues .........L.! 18,755,998
28 Proceeds used to advance refund prior issues .........
, [. 0
29 853,180
30
Total (add lines 24 through 28) .......................
1::i004,854j Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount . . - here)
-
- gnmj 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 - - - . llli'- 29207 years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded . - . - - N/A years
33 Enter the last date on which the refunded bonds will be called (MM/DDCñ'Y 12105/2016
34 Enter the date(s) the refunded bonds were issued (MM/DD/YYYY) 09/2712006
For Paperwork Reduction Act Notice, see separate instructions. Cat. No, 53773S Form 8038-G (Rev. 9-2011)
Form 8038-G (Rev. 9-2011)
Page 2
35 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) . . 0
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
0
b Enter the final maturity date of the GIC
C
(GIC) (see Instructions) ...........................36a
Enter the name of the GIC provider
37 Pooled financings: Enter the amount of the proceeds of this Issue that are to be used to make loans all
to other governmental units .........................37 0
38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box 11 and enter the following information:
b Enter the date of the 'master pool obligation 0, November3, 2016
C Enter the EIN of the Issuer of the master pool obligation 92-6001185
d Enter the name of the Issuer of the master pool obligation Alaska Municipal Bond Bank
39 If the issuer has designated the issue under section 265(b)(3)(13)(1)(11I) (small issuer exception), check box . 111- LI
40 If the issuer has elected to pay a penalty In lieu of arbitrage rebate, check box ............. LI
41a If the Issuer has Identified a hedge, check here LI and enter the following information:
b Name of hedge provider -
C Type ofhedge
d Term of hedge
42 If the issuer has superintegrated the hedge, check box ..................... LI
43 If the Issuer has established written procedures to ensure that all rronquallfled bonds of this issue are remediated
according to the requirements under the Code and Regulations (see Instructions), check box .........LI
44 If the issuer has established written procedures to monitor the requirements of section 148, check box .....' LI
45a If some portion of the proceeds was used to reimburse expenditures, check here ' E1 and enter the amount
of reimbursement $1,650,000
b Enter the date the official intent Was adopted August 13, 2012
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
Signature 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
and process is re
Consent
rn to thle tih ed above.
l \'],\.O D Robert N. Bartholomew, Finance Director
~lgngture of Issuer's authorized representative Date Type or print name and title
Paid Print/Type preparer's name slat Date Check LI rTIN
Preparer Robert Statin
P
I
self-employed P01485649
Use Only Firm's name . K&L sates LLP Firm's EIN 250921018
Firm's address ' 925 Fourth Avenue, Suite #2900, Seattle, WA 98104-1158 1 phone no, 2066231580
Form 8038-G (Rev. 9-2011)
K&L GATES LLP
925 FOURTH AVENUE
SUITE 2900,
SEATTLE, WA 98104-1158
T +1206 623 7580 F +1206 623 7022 klgates corn
December 20, 2016
VIA CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Department of the Treasury
Internal Revenue Service Center
Ogden, UT 84201
Re: City and Borough of Juneau, Alaska
General Obligation Bond, 2016 and General Obligation School Refunding Bond,
2016
Ladies and Gentlemen:
Enclosed please find an IRS Form 8038-G relative to the above-captioned issue.
Please acknowledge receipt of the 'same by signing the enclosed, duplicate copy of this letter
where indicated, and returning it to me in the enclosed pre-addressed envelope.
Thank you for your assistaiice in this matter
Very truly yours,
K&L GATES LLP
4
Kerry Salas
Senior Paralegal
Enclosures
I hereby acknowledge receipt of IRS Form 8038-0 as submitted by the City and Borough
of Juneau, Alaska, regarding its General Obligation Bond, 2016 and General Obligation School
Refunding Bond, 2016.
Date: By:
500191179 vi
klgates.com
AFFIDAVIT OF MAILING
STATE OF WASHINGTON)
) SS.
COUNTY OF KING )
*t e
being duly sworn, deposes and ssat h a
citinUnit eI States and over the age of eighteen years; that hLshj_a resident of
County, Washington.
That on December C) , 2016, at a. . p.m. &used IRS Form 8038-G,
completed by the City and Borough of Juneau, Alaska, wit respect to its General Obligation
Bond, 2016 and General Obligation School Refunding Bond, 2016, to be mailed by depositing
the same in the United States mail, in a sealed envelope, certified delivery, first class, postage
prepaid, properly addressed to the Department of the Treasury, Internal Revenue Service Center,
Ogden, Utah 84201.
7 61 I.'o 000/ Lj 7L/
I certify that I know or have satisfactory evidence th I y I' ' V,t.k 5 is
the person who appeared before me, and said person acknowledged at h she 'gned this
instrument, and acknowledged it to be his, and voluntary act for the uses and purposes
mentioned in the instrument.
Dated:
CE A.
ssIo
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(Use this snace for notarial stama/seal)
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I1 Return RecolpvFee
(Endorsement Rsqplred)
Fost9iark
Restricted Delivery Fee
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Iii Total Postage & Fees $rq _J
Sent To
Department of the Treasury
I Internal Revenue Service Center
or PO Box No. N
Ogden, UT 54201
City, State, ZIP-r-4