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Tab_13380, Form (Rev. April 2011) Department of the Treasury Internal Revenue Service I Reportinci Authority I nformation Return for Tax-Exempt Private Activity Bond Issues OMB No. 1545-0720 (Under Internal Revenue Code section 149(e)) - See separate instructions. Check if Amended Return Do. I Issuer's name 2 Issuers employer Identification number City of Ketchikan, Alaska 92-6000082 3a 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 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) 334 Front Street LEI1 Liii LI] 6 City, town, or post office, state, and ZIP code 7 Date of issue (MM/DD/YYYY) Ketchikan, Alaska 11103/2016 8 Name of issue 9 CUSIP number General Obligation Bond, 2016 (Harbor Improvements); Port Revenue Refunding Bond, 2016 N/A lOa Name and title of officer or other employee of the Issuer whom the IRS may call for more Information lOb Teeplie number cfofl rorothe-snçkteshcvn on 1 0 Robert E. Newell, Jr., Finance Director (907) 225-3111 Type of Issue (Enter the issue price.) Issue Price 11 Exempt facility bond: b Docks and wharves (sections 142(a)(2) and 142(c)) ............... ............................................................ c Water furnishing facilities (sections 142(a)(4) and 142(e)) ...................................................................lic f Qualified residential rental projects (sections 142(a)(7) and 142(d)) (see instructions) ........................hf Meeting 20-50 test (section 142(d)(1)(A)) ............................................................. El Meeting 40-60 test (section 142(d)(1)(13)) .............................................................El Meeting 25-60 test (NYC only) (section 142(d)(6)) ................................................El Has an election been made for deep rent skewing (section 142(d)(4)(B))9 ...........El Yes El No Facility type .lib 33,518,869 a Airport (sections 142(a)(1) and 142(c)) .................................................................................................ha d Sewage facilities (section 142(a)(5)) ...................................................................................................lid e Solid waste disposal facilities (section 142(a)(6)) ................................................................................lie g Facilities for the local furnishing of electric energy or gas (sections 142(a)(8) and 142(0) ..................:ti h Facilities allowed under a transitional rule of the Tax Reform Act of 1986 (see instructions) ..............llh 1986 Act section i Qualified enterprise zone facility bonds (section 1394) (see instructions) ...........................................lii Qualified empowerment zone facility bonds (section 1394(f)) (see instructions) ................................ k District of Columbia Enterprise Zone facility bonds (section 1400A) ...................................................Ilk I Qualified public educational facility bonds (sections 142(a)(13) and 142(k)) ......................................Ill m Qualified green building and sustainable design projects (sections 142(a)(14) and 142(1)) ................urn in Qualified highway or surface freight transfer facilities (sections 142(a)(1 5) and 142(m)) ....................un o Other (see instructions) _ p Qualified New York Liberty Zone bonds (section 1400L(d)) q Other (see instructions) _._____ _ 12a Qualified mortgage bond (section 143(a)) ...........................................................................................12a b Other (see instructions)- - ------- 13 Qualified veterans' mortgage bond (section 143(b)) (see instructions) .............................................. No. Check the box if you elect to rebate arbitrage profits to the United States ........................El 14 Qualified small issue bond (section 144(a)) (see instructions) ............................................................- Check the box for $10 million small issue exemption...........................................................El 15 Qualified student loan bond (section 144(b)) ......................................................................................is 16 Qualified redevelopment bond (section 144(c)) ..................................................................................16 17 Qualified hospital bond (section 145(c)) (attach schedule—see instructions) .....................................17 18 Qualified 501(c)(3) nonhospital bond (section 145(b)) (attach schedule—see instructions) ................18 Check box if 95% or more of net proceeds will be used only for capital expenditures ..... No. 0 19 Nongovernmental output property bond (treated as private activity bond) (section 141(d)) ...............19 20a Other (see instructions) b New York Liberty Zone advance refunding bond (section 1400L(e)) (see instructions) c Other. Describe (see instructions) - . lip iiq 12b 13 14 20b 20c For Paperwork Reduction Act Notice, see separate instructions, cat. No. 49973K Form 8038 (Rev. 4-2011) Page 2 I (a) Final maturity date I (b) Issue price (c) Stated redemption price at maturity (d) Weighted average maturity (e) Yield L. 1210112035 $ 33,518,869 $ 29,400,000 11.339 years 2.5984% IF Uses of Proceeds of Issue (including underwriters' discount) Amount Proceeds used for accrued interest .....................................................................................................22 Issue price of entire issue (enter amount from line 21, column (b)) .....................................................23 Proceeds used for bond issuance costs (including underwriters' discount) 24 230,110 Proceeds used for credit enhancement .........................................................25 24,303 Proceeds allocated to reasonably required reserve or replacement fund 26 0 Proceeds used to currently refund prior issue (complete Part VI) ................27 31,264,456 Proceeds used to advance refund prior issue (complete Part VI) ................28 0 Add lines 24 through 28 ....................................................................................29 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) 0 33,518,869 31,494,566 o 2,000,000 Description of Property Financed by Nonrefunding Proceeds Caution: The total of lines 31a through e below must equal line 30 above. Do not complete for qualified student loan bonds, qualified mortgage bonds, or qualified veterans' mortgage bonds. 31 Type of Property Financed by Nonrefunding Proceeds: a Land ................................................................................................................................................... bBuildings and structures .................................................................................................................... Equipment with recovery period of more than 5 years d Equipment with recovery period of 5 years or less e Other. Describe (see instructions) 32 North American Industry Classification System (NAICS) of the projects financed by nonrefunding proceeds. NAICS Code Amount of nonrefunding proceeds NAICS Code Amount of nonrefunding proceeds a 237990 $ 2,000,000 c $ b $ d $ •TTh!Ai Description of Refunded Bonds (Complete this part only for refunding bonds.) 33 Enter the remaining weighted average maturity of the bonds to be currently refunded ..........................11.44 years 34 Enter the remaining weighted average maturity of the bonds to be advance refunded ..........................- NIA years 35 Enter the last date on which the refunded bonds will be called .............................................................- 112 / 05 /2016 36 Enter the date(s) the refunded bonds were issued 07/2612006 I1WlI Miscellaneous 37 Name of governmental unit(s) approving issue (see the instructions) City Council of the_ City pf Ketchikan, Alaska on - 38 Check the box if you have designated any issue under section 265(b)(3)(13)(1)(III) ................................................................LI 39 Check the box if you have elected to pay a penalty in lieu of arbitrage rebate .......................................................................- LI 40a Check the box if you have identified a hedge and enter the following information .................................................................. L LI b Name of hedge provider c Type ofhedge _ d Term ofhedge 41 Check the box if the hedge is superintegrated .......................................................................................................................- LI 42a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (GIC) lo- b Enter the final maturity date of the GIC .......................................................................................................r c Enter the name of the GIC provider 43 Check the box if the issuer has established written procedures to ensure that all nonqualified bonds of this issue are remediated in accordance with the requirements under the Code and Regulations (see instructions) .................................. 44 Check the box if the issuer has established written procedures to monitor the requirements of section 148 ...................... 45a Enter the amount of reimbursement if some portion of the proceeds was used to reimburse expenditures.. - $1,513,000 b Enter the date the official intent was adopted .................................................................................... [ó' 05 / 2012 46 Check the box if the issue is comprised of qualified redevelopment, qualified small issue, or exempt facilities bonds and provide name and EIN of the primary private user .................................................................................................................. LI Name . EIN Form 8038 (Rev. 4-2011) Form 8038 (Rev, 4-2011) Li} Description of Bonds (Complete for the entire issue for which this form is being filed.) 23 WZA 26 27 28 29 30 Form 8038 (Rev. 4-2011) Page 3 Volume Caps - Amount 47 Amount of state volume cap allocated to the issuer. Attach copy of state certification ................47 48 Amount of issue subject to the unified state volume cap ...................................................................48 49 Amount of issue not subject to the unified state volume cap or other volume limitations: 49 33,518,869 a Of bonds for governmentally owned solid waste facilities, airports, docks, wharves, environmental enhancements of hydroelectric generating facilities, or high-speed intercity rail facilities ................49a 33,518,869 b Under a carryforward election. Attach a copy of Form 8328 to this return ........................................49b c Under transitional rules of the Tax Reform Act of 1986. Enter Act section - 49c d Under the exception for current refunding (section 146(i) and section 1313(a) of the Tax Reform Act of 1986) 49d 50a Amount of issue of qualified veterans' mortgage bonds ...............................................................................50a b Enter the state limit on qualified veterans' mortgage bonds ...............................................................50b 51a Amount of section 1394(t) volume cap allocated to issuer. Attach copy of local government certification 51a b Name of empowerment zone '_____ 52 Amount of section 142(k)(5) volume cap, allocated to issuer. Attach copy of state certification 52 Under penalti o perjury, I declare that jLeexamined this return, and accompanying schedules and statements, and to the best of my knowledge and Signature belief, they fe tr ,,fôrreo, and compi e.clare that I consent to the IRS's disclosure of the issuer's return information, as necessary to process and this return, th ptsontythat I u(h . Consent . . 11/03/2016 Robert E. Newell, Jr:, Finance Director Signature of issuer's authorized representative Date Type or print name and title PrintlType preparer's name Prepaei signature J Date Check if Preparer's PTIN Paid arer Darren C. McHugh ()tjfl.fl ,, f4CIØ1 11/03/2016 self-employed P01296493 Prep Use Firm's name Stradling Yocca Carlson & Raugh, P.C. Firm's EIN . 95-3347002 Firm's address P. 1400 16th Street, Suite 400, Denver, CO 80202 Phone no. (720) 616-6980 Form 8038 (Rev. 4-2011) DiV I (V!d V D(OJ'AiIIIiC I, Cynthia A. Nevins, a paralegal at Stradling Yocca Carlson & Rauth, P.C., in Seattle, Washington, certify that on this day I mailed the original IRS Form 8038 relating to the issuance of: City Ketchikan, Alaska $1,765,000,000 General Obligation Bond, 2016 (Harbor Improvements) and $27,635,000 Port Revenue Refunding Bond, 2016 Issue Date: November 3, 2016 Dated Date: November 3, 2016 To the Department of the Treasury, Internal Revenue Service Center, Ogden, Utah 84201, by certified mail, return receipt requested (7016 1970 0000 9940 2973). Dated December 15, 2016. 0 CynthiA A. Nevins DOCS SF/ 134843v1/2OQ66-003O L l - m m - 0' m . -I..I ru Er l' C3 L3 )UJ'_ Certified Mall Fee -. • 1• ______ 117 fl-s____________________ • ________________ Ir Er Extra Services & Fees (check box, odd foe as appropriate) C3 0 Return Receipt (iarriccpy) $ C3 I C3 C3 0 Return Receipt (electronic) $ ______________ Postmark DD Certified Melt Restricted Delivery $ _____________ Here • _________________C3 C3 D Adult Signature Required $ • DAdult Si gnature Restricted Delivery $ • ________________ Postage N N • ____ Er 117 Total Postage and Fees 1l • ___________ .D r1 H D 6ertt7b oi?éiFandfsC7 Fkk N N N-ir y3 j L Complete items 1, 2, and 3. A Signature i 12 Print your name and address on the reverse x 0 Agent so that we can return the card to you. 0 Addressee ta Attach this card to the back of the mailpiece, B. Received by (Printed Name) I C. Date of Delivery or on the front If space permits. I 1. Article Addressed to: D. Is delivery address different from Item 1? 0 Yes If YES, enter delivery address below: 0 No Department of Treasury Internal Revenue Service Center I Ogden, UT 84201 3, Service Type 0 PriorIty Mall Express5 I IIII tII 111111 I I Ill 11111 1 I 0 AdultSignature 0 Registered Mail'- I 111 1 0 AdultSigrrature Restricted Delivery 0 Registered Mail Restricted 9590 9402 2007 6123 4171 ertifed MaJl© Delivery 19 a Certified Mail Restricted Delivery Cl Return Receipt for n Collect on Delivery Merchandise I QAriiclret'Jrjmt-r_ITranefarfrcma ,JcJabpIL_ _-_ jJ olltn0ellvery Restricted Delivery 0 Signature Conflmistlorrml 7016 1970 0000 9940 2973 Restricted [Delivery OSignetureCcntimistion Restricted Delivery —--re sOoo) PS Form 3811, July 2015 PSN 7530-02-000-9053 - Domestic Return Receipt First-Class Mail - 0 Postage & Fees Paid uSPs Permit No. 0-10 United States Sender: Please print your name, address, and ZIP+45 in this box' Postal Service Cynthia A. Nevins Stradling Yocca Carlson & Rauth PC 800 Fifth Avenue, Suite 4100 Seattle, WA 98104