Tab_198ai Form OUaJQ)
(Rev. September 2011)
Department of the Treasury
Internal Revenue Service
Report
I nformat i on Return for Tax-Exempt Governmental Obligat i ons
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 8038-0G.
Authority If Amended Return, check here Ill I
Issuer's name 2 Istuer's employer identification number (EIN)
City of Nome, Alaska 92-0019767
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 mall Is not delivered to street address) Room/suite 5 Report number (For IRS Use Only)
P.O. Box 281 i
6 City, town, or post office, state, and ZIP code 7 Date of Issue
Nome, Alaska 99162 November 3, 2016
B Name of Issue 9 CUSIP number
General Obligation Refunding Bond, 2016 Series A None
1 Oa Name and title of officer or other employee of the Issuer whom the IRS may call for more Information (see lab Telephone number of officer or other
instructions) - employee shown on lOs
Julie Liew, Finance Director 907.443.6620
Type of Issue (enter the issue price). See the instructions and attach schedule.
Education ......................................11
Health and hospital ................................12
Transportation ...............................13
Public safety ..............................14
Environment (including sewage bonds) .......................
Housing .................................16
Other. Describe
688,753
Utilities ................................17
If obligations are TANS or RANs, chock only box 19a ............. El
If obligations are BANS, check only box 19b ..................El
If obligations are in the form of a lease or installment sale, check box ........ El
Description of Obligations. Complete for the entire issue for which this form is being filed.
(a) Final maturity date I (b) Issue price (o) Stated redemption
price at maturity
(d) Weighted
average maturity (a) Yield
12(01/2020 688,753 $ 650,000 2.6111 years 2.5985 %
11
12
13
14
15
16
Iu
19
20
11
Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued interest ..............,..,,.. 0
23 688,153 23 Issue price of entire issue (enter amount from line 21, column (b))
24 Proceeds used for bond issuance costs (including underwriters' discount). 24 5,939
25 Proceeds used for credit enhancement ............LJ 444
26 Proceeds allocated to reasonably required reserve or replacement fund
. f 26
27 Proceeds used to currently refund prior issues ......... 679,578
28 Proceeds used to advance refund prior issues .........[ 28 I 0]
29 685,961
30
Total (add lines 24 through 28) .........................29
t - rfunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) . . 30 2,792
Description of Refunded Bonds. Complete this part only for ref ndinçbonds.
31 Enter the remaining weighted average maturity of the bonds to be currently refunded , . . . 2.5943 years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded . ______years
33 Enter the last date on which the refunded bonds will be called (MM/DD/YYYY) ..,... - 12/05/2016
34 Enter the date(s) the refunded bonds were issued (MM/OD/YYYY) 01/31/2007
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 83773S Form 8038-G (Rev. 9-2011)
Form 8038-G (Rev. 9-2011) Page 2
i 'A l Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) . . . J35 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 GIG provider DID,
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 ZI 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 - . . . 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 - -
C Type ofhedge
d Term of hedge 11>
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 remedlated
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 ...... to 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 psI'aa of penury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
Signature and L/ia1, Fiy rt true correct, and complete. further declare that consent to the IRS's disclosure of the issuer's return information, as necessary to
and pro $ssth return, to the person that I have authorized above.
Consent
-
t4)( k Julie Liew, Finance Director
n's authorized representative_ Data V 'type or print name and title
Paid Print/Type preparer s name Pr P/ki ai9n)id're jJ 4 Date Check E] If PuN
Preparer Thomas Khnkner - & self employed P01874546
Use Only Firm's name Birch Horton Bittner & o1
'
Firm'sL EIN 920046806
Finn's address s 1127 West 7th Avenue, Anchorage AK 99501 Phone no, 907.203.7219
Form 8038-0 (Rev. 9-2011)
4'
Birch Horton Bittner & Cherot
a professional corporation Thomas F. Klinkner
Respond to Anchorage Office
T 907.263.7219 F 907.276.3680
tklinkner@bhb.com
November 8, 2016
ICERTIFIE DJt!i!.1
Department of the Treasury
Internal Revenue Service Center
Ogden, UT 84201-0074
RE: City of Nome, Alaska
Our File No.: 505,301.44
To Whom It May Concern:
ISSUE DATE DESCRIPTION
11/3/2016 Form 8038-G - GO Refunding Bonds, 2016 Series A
File original [ Prepaid return envelope enclosed
[ ] For your information/files [ ] For signature/notarize
[ ) Per your request [ ] For filing
[ J For review and comment [ ] Return to our office
[] Returned to you t ] Forward to:
Please call Tom Klinkner at (907) 276-1550, if you have any questions.
Yours truly,
BIRCH HORTON BITTNER & CHEROT
rL1A:
Thomas F. Klinkner '?
TFK:lcj
Enclosure
1127 West Seventh Ave., Anchorage, AK 99501-3301 1156 15th St. N.W., Ste. 1020, Washington, D.C. 20005-1754
T 907.2761550 • 800.478.1550' F 907.276.3680 T 202.659.5800 • F 202.659.1027
505301\44\00558075
LAW OFFICES
BIRCH HORTON BTTNER & CHEROT -
A PROFESSIONAL CORPORATION :
1127 WEST SEVENTH AVENUE
ANCHORAGE, ALASKA 99501
H -]
505,301.44 91 71fl8 2133 3937 2497 3822
DEPARTMENT OF THE TREASURY
INTERNAL REVENUE SERVICE CENTER
OGDEN LIT 84201-0074
LUIflIflT
From: auto-replyusps.com
Sent: Monday, November 14, 2016 9:12 AM
To: Linda Julian
Subject: USPS item Delivered, To Agent for Shipment 9171082133393724973822
Tracking Number: 9171082133393724973822
Hello
Linda
Julian,
Thank you
for using
USPS.com .
This is a post-only message. Please do not respond.
Linda Julian has requested that you receive a USPS Tracking® delivery or delivery attempt update, as
shown below.
USPS Tracking® e-mail update information provided by the U.S. Postal Service.
Tracking Number: 9171082133393724973822
Expected Delivery Date: November 14, 2016
Service Type: Certified MailTM
Shipment Activity Location Date & Time Shipping
Partner
Delivered, To Agent OGDEN, UT 84201 November 1
2016 10:20 am
In Transit to Destination November 11,
11:47 pm
Departed USPS Facility SALT LAKE CITY, UT November 10,
84199 2016 10:53 pm
Arrived at Unit SALT LAKE CITY, UT November 10,
84199 2016 11:48 am
Arrived at USPS Destination Facility SALT LAKE CITY UT November 10,
84199 2016 11:47 am
In Transit to Destination November 9,
2016 9:50 pm
Departed USPS Facility ANCHORAGE, AK 99530 November 9,
2016 3:28 am
Arrived at USPS Origin Facility ANCHORAGE, AK 99530 November 8,
IV
2016 9:50 pm
Departed Post Office ANCHORAGE, AK 99517 November 8,
2016 6:20 pm
Acceptance ANCHORAGE, AK 99517 November 8, 2016 6:09 pm
Reminder: USPS Tracking® by email
Date of email request: November 9,2016
Future activity will continue to be ernailed for up to 2 weeks from the Data of Request shown above. If
you need to initiate the USPS Tracking® by email process again at the end of the 2 weeks, please do
so at the USPS Tracking® site at http://www ,usps.com/shippi ng/uspgtrackingfaqs htm
Results provided by the U.S. Postal Service.
Want to Track on the go?
You can track your packages using USPS Text TrackingTM by texting your tracking number to 28777
(2USPSTM) or selecting the Text Update option on our USPS Tracking® site Standard Message and
Data Rates may apply.
For more information go to https://www.usps.com/text-tracking/welcome.htm
Download USPS Mobile®
FT
This is an automated email please do not reply to this message. This message is for the designated
recipient only and may contain privileged, proprietary, or otherwise private information. If you have
received it in error, please delete, Any other use of the email by you is prohibited.
Total Control Panel LQm
To: Message Score: I High (60): l'ass
From: prvs=3I26329e95=auto My Spam Blocking Level: Custom Medium (75): Pass
reply@usps.com Low (90): Pass
Block this sender Custom (50): Pass
Bl ock usps.com
This message was delivered because the content filter scare did not exceed your filter level