Tab_112Form 80386 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 I '- See separate instructions.
Internal Revenue service Caution: If the issue price is under$100,000, use Form 8038-CC.
Renortinct Authority If Amended Return, check here - Li
- 1 Issuers name - 2 Issuer's employer identification number (EIN)
City and Borough of Juneau, Alaska 92-0038816
Se Name of person (other than Issuer) with whom the IRS may communicate about this return (see instructions) Sb Telephone number of other person shown on 3a
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 15 1 L
6 City, town, or post office, state, and ZIP code 7 Date of issue
Juneau, Alaska 99801 11/0312016
B Name of issue 9 CUSIP number
General Obligation Bond, 2016 and General Obligation School Refunding Bond, 2016 None
lOa 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 I Oa
Robert Bartholomew, Finance Director 907-586-5215
T1III Type of Issue (enter the issue price). See the instructions and attach sofledule
11 Education .................................11 18,841,115
-
12 Health and hospital ............................12
13 Transportation .............................13 3,016,919
14 Public safety ...............................14
15 Environment (including sewage bonds) ...................___________
16
17
Housing ................................16
18
Utilities .................................17
Other, Describe 18
19 If obligations are TANS or RANs, check only box 19a, ............ - LII
If obligations are BANS, check only box l9b .............. 00- LI
20 If obligations are in the form of a lease or installment sale, check box ........00,LI
1ThI II Description of Obligations. Complete for the entire issue for which this form is being filed.
(a) Final maturity date
I aage (b) Issue price
I
(c) stated redemption
I price at maturity
(d) Weighted
ty (e) Yield
21 1 12101/2026 1 $ 21,858,0341 $ 20,210,0001 3.6152 years I 2.5985 %
I'TIkYI Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued interest ......................1 22 0
-
23 Issue price of entire Issue (enter amount from line 21, column (b)) ...........L23 21,858,034
- -
24 Proceeds used for bond issuance costs (including underwriters' discount). . 24 97,182 I
25 0
26 Proceeds allocated to reasonably required reserve or replacement fund 26 0
27
Proceeds used for credit enhancement ..............25
18,755,998
28
Proceeds used to currently refund prior issues ..........27
Proceeds used to advance refund prior issues ...........28 0
29 Total (add lines 24 through 28) ........................29 18,853,180
-
30 Nonrefunding proceeds of the issue (subtract line 29 from lIne 23 and enter amount here) , . . 30 1 3,004,854
JTh3I 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 . . . - 2.9207 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/DD/YYYY) 12105/2016
34 Enter the date(s) the refunded bonds were issued - (MM/DDr'YYY) 09/27/2006
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 637735 Form 8038-G (Rev. 9-2011)
Form 8038-0 (Rev. 9-2011) page 2
I1WAI Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . . 35 0
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
(GIC) (see instructions)
......,........,.........
0
b Enter the final maturity date of the GIG
C Enter the name of the 010 provider
37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans
to other governmental units .........................0
38a if this issue is a loan made from the proceeds of another tax-exempt issue, check box 1 and enter the following information:
b Enter the date of the'master pool obligation November 3,2016
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)(B)(1)(1I1) (small issuer exception), check box . . L
40 If the Issuer has elected to pay a penalty In lieu of arbitrage rebate, check box .............. El
41a If the issuer has Identified a hedge, check here and enter the following information:
b Name of hedge provider
C Type ofhedgePo-
d Term of hedge 00,
42 If the issuer has superintegrated the hedge, check box ..................... D
43 If the Issuer has established written procedures to ensure that all nonqualifled bonds of this issue are remediated
according to the requirements under the Code and Regulations (see instructions), check box ........
44 If the issuer has established written procedures to monitor the requirements of section 148, check box .....p',- LI
45a If some portion of the proceeds was used to reimburse expenditures, check here l 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 beat of my knowledge
Signature and belief, they are true, correct, an complete. i further declare that I consent to the IRS's disclosure of the issuer's return Information as necessary to
at i ha "'"-"18d above. and process
Consent L(.o Robert N. Bartholomew, Finance Director
SIgn9ture of Issuer's authorized representative Date Type or print name and title
Paid PrintlType preparer's name I Pre I at Date check LI PT"
seif-employed P01485649 Preparer Robert Starin
Use Only Firm's name K&L Gates LLP Firm's EIN 250921018
Firm's address Phone no.. 206-623.7580 925 Fourth Avenue, Suite #2900, Seattle, WA 98104-1158
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 klgatescom
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
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
kgates.com
AFFIDAVIT OF MAILING
STATE OF WASHINGTON)
) ss.
COUNTY OF KING )
*te
being duly sworn, deposes and sat h a
citiiUnitel States and over the age of eighteen years; that h&sj.-a resident of
County, Washington.
That on December 20 , 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. SA
75 jv ovol 15 /
I certify that I know or have satisfactory evidence that'4
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the person who appeared before me, and said person acknowledged t h she jgned this
instrument, and acknowledged it to be his, and voluntary act foe uses and purposes
mentioned in the instrument.
Dated: c I
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Nota Puic
PrinNae
My commission expires
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Certified Fee
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Return Recelpt'Fea —- . Postmark t
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RestrtOtad Delivery Fee
(Endorsement Required)
lii Total Postage & Fees $ _J
Sent To
Department of the Treasury
Internal Revenue Service Center
N or PC Sax No.
- Ogden, UT 84201
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