Tab_187Form 8038-G Informati on Return for Tax-Exempt Governmental Obligations
(Rev. September 2011)
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Under Internal Revenue Code section 149(e)
Department of the Treasury
See separate instructions.
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OMB No. 1545-0720
Internal Revenue Service Caution: If the issue price is under $100,000, use Form 8038-GC.
WEIMIM Rtnnrfinri Atjthnritv - If Amended Return, check here Li
1 Issuer's name - 2 Issuer's employer identification number (EIN)
Kodiak Island Borough, Alaska 920030845
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)
710 Mill Bay Road 3 IdIi:.
6 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
General Obligation School Refunding Bond, 2016 N/A
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 Oa
Dora Cross, Finance Director 907486-9323
IT1II Type of Issue (enter the issue price). See the instructions and attach schedule
11 Education ...............................-1:!-
12 Health and hospital .......................... 12 .__________
13 Transportation ............................ 13 .__________
14 Public safety ............................. 14 .__________
15 Environment (including sewage bonds) .....................15
16 Housing ...............................
17 Utilities .............................. 17 ________________
18 Other. Describe Advance refunding of General Obligation School Bond, 2008 Series A 18 5,711,205
19 If obligations are TANS or RANs, check only box 19a ............. 111p. LI
31 If obligations are BANS, check only box 1 9b LI
20 If obligations are in the form of a lease or installment sale check box LI j 11
ITH II Description of Obligations. Complete for the entire issue for which this form is being fled.
(a) Stated redemption (d) Weighted
(a) Final maturity date (b) Issue price (e) Yield price at maturity average maturity
21 12/01/2027 5,711,205 $ 4,905,000 7.106 years 2.5985 %
IJTIk'1 Uses of Proceeds of Bond Issue (including underwriters' discount) -
22 Proceeds used for accrued interest ......................22
23 Issue price of entire issue (enter amount from line 21, column (b)) . . .........
23 5,711,205 -
____24 -- Proceeds used for bond issuaric"osts (Including ---------24 -44;341
25 Proceeds used for credit enhancement .............25 3,349
26 Proceeds allocated to reasonably required reserve or replacement fund 26 _______
27 Proceeds used to currently refund prior issues ..........27
28 Proceeds used to advance refund prior issues ..........28 5,661,892
29 Total (add lines 24 through 28) .........................29 5,709,582 -
30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) . . .30 1,623
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I1i1W1 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 . . . . years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded . . . .
op.
6.4255 years
33 Enter the last date on which the refunded bonds will be called (MM/DD/YYYY) 04/01/2018
34 Enter the date(s) the refunded bonds were Issued (MM/DD/YYYY) 04/15/2008
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 63773S Form 8038-G (Rev. 9-2011)
Form 8038-0 (Rev. 9-2011) Page 2
35 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) . . . 35
36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract
b Enter the final maturity date of the GIG Ol-
e
(GIG) (see instructions) ..........................36a
Enter the name of the GIG 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
38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box 0 and enter the following information:
b Enter the date of the master pool obligation
C Enter the EIN of the issuer of the master pool obligation bo.
d Enter the name of the issuer of the master pool obligation
39 If the issuer has designated the issue under section 265(b)(3)(B)(i)(I1I) (small issuer exception), check box . . . - 0
40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box ............. 0
41a If the issuer has identified a hedge, check here Do, 0 and enter the following information:
b Name of hedge provider '
C Type of hedgePo-
d Term of hedges
42 If the issuer has superinteg rated the hedge, check box ..................... 0
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
45a If some portion of the proceeds was used to reimburse expenditures, check here - 0 and enter the amount
of reimbursement ....... . Do-
b Enter the date the official intent was adopted
Under penalties of peijury, 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 this return, to the person that I have authorized above. Dora Cross
Consent XP\Cs. 6(r 11/03/2016 Finance Director
Signature of issuer's authorized representative Date Type or print name and title
if IPTIN
Paid
_____
Print/Type preparer's name Preparer's signature Date Check 0
Preparer-- Marc R. Greenotigh 444e.1i rtL# -11/03/2016 salf-employed P01061698
Use Only Firm's name Do. Foster Pepper PLLC Firms EIN '- 91-0606972
Firms address p.1111 Third Avenue, Suite 3000, Seattle, WA 98101 I Phone no. (206) 447-4400
Form 8038G (Rev. 9-2011)