Tab_165(Rev. September 2011)
Department of the Treasury
Int"mal Revenue Service
Ranorti
Information Return for Tax-Exempt Governmental Obligations
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-GC.
If Amended flethi'n, check here
I Issuer's name 2 Issuer's employer identification number (EIN)
City of Kodiak 92-6000083
Ba Name of person (other than ssuer) with whom the IRS may communicate about this return (see instructions) 31a 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 Say Road JJ
3 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
Boat Lift Special Facility Revenue Refunding Bonds, Series 2016A and 2016B 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 11 Oa
Kelly Mayes, Finance Director 901.486.8659
I I or issue enter tne Issue pI'1003. See the instructions and attach schedule.
11
12
13
14
15
16
17
19
20
Education ..........,,,,,,,,,,,,, ... .,,,,
Health and hospital .........,,.,.,,,,,,,.,,,.
Transportation
Public safety .........,,,,,.,.,.,,,,.,,,,,
Environment (including sewage bonds)
Housing
Utilities ..........,,,,,,,,..,,,,,,,,,
18 Other. Describe
If obligations are TANS or RANs, check only box 19a .............
If obligations are BANS, check only box 19b ................-
If obligations are in the form of a lease or installment sale, check box ........
0
0
El
11
12
i! 4,574,093
14
15
P17
, Description of Obligations. Complete for the entire issue for which this form is being filed.
- i (a) I-nal maturity date (bI Issue price (c) Stated redemption
price at maturity
(d) Weighted
average maturity (e) Yield
21 12/01/2037 1 s4,574,0931 4,360,0001 12.7861 years 2.5985 %
.1 Uses of Proceeds of Bond issue (including underwritersr discount)
22 0
23
Proceeds used for accrued interest ...........................22
Issue price of entire issue (enter amount from line 21, column (b)) 23 4,574,093
24 Proceeds used for bond issuance costs (including underwriters' discount). L 24 39,050
25
26 Proceeds allocated to reasonably required reserve or replacement fund
.
[26 342,025
27
Proceeds used for credit enhancement .............25 2,977
28
Proceeds used to currently refund prior issues ..........27 0
Proceeds used to advance refund prior issues ..........28 4,189,679
29 4,573,731
=
30
Total (add lines 24 through 28) ..........................29
Nen'-"fundlng proceeds of the issue (subtract line 29 from line 23 and enter amount here) 30 362
I)eSOrIptiOn of Refunded Bonds Complete this part only for refunding bonds.
31 Enter the remaining weighted average maturity of the bonds to be currently refunded
32 Enter the remaining weighted average maturity of the bonds to be advance refunded .Do- 131466 years
33 Enter the last date on which the refunded bonds will be called (MM/DDIYYYY) ..,,,, 111~ 09/01/2017
34 Enter the date(s) the refunded bonds were issued 1MM/DDTYYYY)12/04/2007, 01/21/2009
For Paperwork Reduction Act Notice, see separate instructions. Oat. No. 63773S Form 8038-G (Rev. 9-2011)
Form 8038-5 (Rev, 9-2011) Page 2
-
Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . 351
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
(GIC) (see instructions) ...........................36aL.. _ci
b Enter the final maturity date of the GIG
c Enter the name of the GtC 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 .........................37 0
-
38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box and enter the following information:
b Enter the date of the master pool obligation k.- November 3, 2016
o 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)(111) (small issuer exception), check box . . . 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 Do-
C Type ofhedge 10
d Term ofhedge
42 If the issuer has superintegrated the hedge, check box ......................LI
43 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 ........
44 If the issuer has established written procedures to monitor the requirements of section 148, check box ..... 0, LI
45a If some portion of the proceeds was used to reimburse expenditures, check here LI and enter the amount
of reimbursement ................
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 knowledg
Signature and belief, they are true, correct, and complete. I further declare that I consent to the IRS's disclosure of the issuers return Information, as necessary to
and process It a r urn, person that I have authorized above,
Consent k Kelly Mayes, Finance Director
Cigna tire of 14AOC3 au c ii representative 9,#te V Type or print name and title
Paid Print/Type preparer a name s rnrt .f/J// Date Check 17 TIN
Preparer Thomas Khnkner self-arnployedi P01874546
Use Only Firm's name is. Birch Horton Bittner & Cherot J Firma ON is 92.0046806
Firms address is- 1127 West 7th Avenue, Anchorage AK 99501 Phone no. 907.263.7219
Form 8038G (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
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 8083-G - Boat Lift Special Facility Revenue Refunding Bonds,
Series 2016A and 2016B
File original [ ] Prepaid return envelope enclosed
] For your information/files ] For signature/notarize
Per your request [1 For filing
I For review and comment [ J Return to our office
Returned to you [I Forward to:
Please call Tom Klinkner at (907) 276-1550, if you have any questions.
Yours truly,
BIRCH HORTON BITTNER & CHEROT
Thomas F. Klinkner
TFK:lcj
Enclosure
1127 West Seventh Ave., Anchorage, AK 99501-3301 1156 15th St. NW., Ste. 1020, Washington, D.C. 20005-1754
T 907.276.1550 800,478,1550 F 907,276.3680 T202.659.5800 F 202.859.1027
505786\83\005581 20
0
BIRCH HORTON BITTNER & CHEROT
1127 WEST SEVENTH AVENUE
ANCHORAGE AK 99501
. I IIiIV
Department of Treasury
Internal Revenue Service
Ogden UT 842010074
IRS
034e74.S66651.175072.305 1 AV 0.376 313
Notice CP152
Tax period November 30, 2016
Notice date December 19, 2016
Employer ID number 926000083
To contact us Phone 14778295500
FAX 8016205555
CITY OF KODIAK
% FINANCE DIRECTOR
PO BOX 1397 Ir4t,. I, IAK AK 99615-131
orm 8038-G
iIIreceivedtIY.I
Acknowledgm en t
)c M111
'1 '1.111111.11 Ii
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 BOAT LIFT SPECIAL FA C I LITY REVENUE
acknowledgment for each one. C n umbe r NONE
Issue date November 3, 2016
-
MUMEMM
Ii, Ithis notice
this tax-exempt bond.
a if a tax piactitioner 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 a Visit www,irs,gov/cpl 52.
For tax farms, instructions, and publications, visit www.irs.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.