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Tab_154Form O38G (Rev. September 2011) Department of the Treasury Internal Revenue Service H .floortinii I nformation Return for Tax-Exempt Governmental Obligations 10, Under Internal Revenue Code section 149(e) OMB No. 1545-0720 ' See separate Instructions. Caution: If the issue price is under $100,000, use Form 8038-CC. If Amendet'l Antiu'r nhcr'.k hwrn III- 1 Issuer's name - - 2 Issuer's employer identification number (EIN) CLy of Kodiak 92-6000083 30 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) 710 Mill Bay Road 13 i 8 City, town, or post office, state, and ZIP code 7 Date of Issue Kodiak, Alaska 99615 November 3, 2016 8 Name of issue -. - 9 CUSIP number Harbor Revenue Refunding Bond, Series 2016A None 1 Oa 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 Oa Kelly Mayes, Finance Director - 907.486.8659 1111 ..iJ type or issue. (enter tne issue. PEfC,) See the. instructions and attach schedule. 11 12 13 14 15 16 17 18 Education Health and hospital Transportation .......,,,,,,,,,,,,,, Public safety .................. Environment (including sewage bonds) ...., . ,.,,,. Housing .,.... Utilities ...,......,,.,,.,,,,,.,.,. Other. Describe 11 . - 13 1,777,098 14 15 ,,,,,, 18 18 - 19 20 If obligations are TANs or FANs, check only box 19a ......... If obligations are BANS, check only box 19b .............-. If obligations are in the form of a tease or installment sale, check box ............ 0 . • 0 Description of Obligations Complete for the entire issue for which this form is ,,being: led La Final maturity date (b) issue price (c) Stated price at maturity [ average maturity (a) Yield 21 I 12/0112037 J 1,777,098 $ 1,680,000 12.2621 at:s 25985 % I Uses of Proceeds of Bond Issue (including underwriters' discount) = __ - 22 Proceeds used for accrued interest 22 0 23 24 Issue price of entire issue (enter amount from line 21, column (b)) ..,.,.,, Proceeds used for bond issuance costs (including underwriters' discount), 24 14,906 23 1,777,09B - 25 26 Proceeds allocated to reasonably required reserve or replacement fund 26 119,556 27 Proceeds used for credit enhancement .............25 1,147 28 Proceeds used to currently refund prior issues ..........27 0 Proceeds used to advance refund prior issues ..........28 .1,640,876 29 qo Total (add lines 24 through 28) ...........................29 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) 1,776,485 = 30 613 Description of Refunded Bonds. Corn fete this part only for funding bonds. 31 32 33 Enter the remaining weighted average maturity of the bonds to be currently refunded Enter the remaining weighted average maturity of the bonds to be advance refunded - Enter the last date on which the refunded bonds will be called (MM/DD/YYYY) 124354 veas 09101/2017 34 Enter the date( the refunded bonds were issued MM/DDmri.Y), 04/2007 For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 637730 Form 8038-G (Rev. 9-201 1) Fnr sn"RG (Rev. 9-2011) Page 2 H Miscellaneous - 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 (GIC) (see Instructions) ..........................3 0 b Enter the final maturity date of the GIC C Enter the name of the GIC provider 11> 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 EJ 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 10, 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)(i)(111) (small issuer exception), check box . . .• LI 40 If the Issuer has elected to pay a penalty in lieu of arbitrage rebate, check box ............. 11. LI 41a If the issuer has identified a hedge, check here LI and enter the following information: b Name of hedge provider ts C Type of hedge d Term of hedge 42 If the issuer has superintegrated the hedge, check box ..................... El If the issuer has established written procedures to ensure that all nonqualified 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 LI and enter the amount of reimbursement .........P- b Enter the date the official intent was adopted 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 theIRS's disclosure of the Issuer's return information, as necessary to and process t*' m(um0 to the person that I have authorized above. Consent 4(4/ Kelly Mayes, Finance Director signg type or print name and this s - rrr representative I ' PrintlType preparers name Date PTIN Paid 7r/ I Check LI It I Preparer Thomas Klinkner self-emPloYedl P01874546 Use Only Firm's name Birch Horton BiUner & Cherot Firms EIN f' 92-0046806 Firms addrese 1127 West 7th Avenue, Anthoraqe AK 99501 IPhone no. 907.263.7219 (Rev. 9-2011) Birch Horton Bittner & Cherot a professional corporation Thomas F. Klinkner Respond to Anchorage Office T 907.263.7219 e F 907.276,3680 tklinkner@bhb.com November 8, 2016 CERTIFIED MAIL p i i iii ii I T1 .1Ii Department of the Treasury Internal Revenue Service Center Ogden, UT 84201-0074 RE: City of Kodiak, Alaska Our File No.: 505,780.158 To Whom It May Concern: ISSUE DATE DESCRIPTION 11/3/2016 Form 8038-G - Harbor Revenue Refunding Bond, Series 2016A File original [] Prepaid return envelope enclosed [1 For your information/files j For signature/notarize Per your request ] For filing For review and comment ] Return to our office (1 Returned to you (1 Forward to: Please call Tom Klinkner at (907) 276-1550, if you have any questions. Yours truly, BIRCH HORTON BITTNER & CHEROT j , Thomas F. Klinkner -' TFK: lcj Enclosure 1127 West Seventh Ave, Anchorage, A1c99501-3301 1156 15th St. NW., Ste. 1020, Washington, D.C. 20005-1754 T907,276,1550 -800.478.1550-F907.276,3680 T2O2.659.5800 F202.659.1027 505785\83\005561 19 BIRCH HORTON BITTNER & CHEROT 1127 WEST SEVENTH AVENUE ANCHORAGE AK 99501 .1". i~ Department of Treasury Tv Internal Revenue Service Ogden UT 84201-0074, 034e75566651.175872.30ee5 1 AV 0.376 373 F I NAN CE [111 +111611111111111 poll III I III I I I I III [I loll 111111111111111111 Notice Tax period November 30, 2016 Notice date December 19, 2016 Employer ID number 92-6000083 To contact us Phone 1-B77-829-5500 FAX 801-620-5555 CITY OF KODIAK 11tts1t PO BOX 1397 KODIAK AK 1I.5J1YI :H*11 Acknowledgment of your November 3, 2016 Form 8038-G We Treceived Lyou r 1 tax-exem pt bond ItsIiri This notice serves as official acknowledgment Tax-exempt bond information that we received your Form 8038-G. If you filed more than one form, you will receive a separate Name of issue HARBOR REVENUE REFUNDING BOND SERIE acknowledgment for each one. CUSIP number NONE Issue date November 3, 2016 Issue price $1,77709800 Maturity date December 1, 2037 Important reminders e Attach a copy of this notice to all of your correspondence and documents related to this tax-exempt bond. a If a tax practitioner or someone else prepared your form, you may want to give them a copy of this notice. (A copy was automatically sent to all representatives authorized with a Power- of-Attorney for this form.) Additional information @ Visit www.irs.gov/cpl 52. For tax forms, instructions, and publications, visit wwwirs.gov or call 1 -800-TAX-FORM (1-800-829-3676), If you have questions about tax-exempt bonds, call TEGE Customer Account Services at 1-877-829-5500. Keep this notice for your records. ET-MM MWITTMIMM