Tab_241(Rev. September 2011)
Form 8038-113
Department of the Trees
ml Revenue Servio
Information Return for Tax-Exempt Governmental Obligations
Caution: If f/to issue price is under $100,000, use Fomi 8038-GC.
Under Internal Revenue Code section 149(0) OMB No 1545-0720
10- See separate instructions.
RnnrHnn Authority If Amended Return, check here No-
- I Issuer's name - 2 Issuers employer identification number (EIN)
City and Borough of Sitka, Alaska 92-0041163
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 Lice Only)
100 Lincoln Street 13
6 City, town, or post office, state, and ZIP code 7 Date of issue
Sitka, Alaska 99835 11103/2016
S Name of Issue 9 CUSIP number
General Obligation Refunding Bond, 2016 None
IOa 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
John Sweeney Ill, Chief Financial and Administrative Officer (907) 747-3294
l?.FT'iIlI Tvbe of Issue (enter the issue nrice. See the instructions and attach schedule.
11 Education.. ...... .......... .... ................ .. .................. ................ .................. ....... ................... ........... ...........
12 Health and hospital ..............................................................................................................................12
13 Transportation .... .......................... ......................................................... ....... ............... .............. ... .......
14 Public safety, ......... .... ........... .. ............................... .. ......... .. ... ....... ...... . ................. ................... .... .... ... ..14
15 Environment (including sewage bonds) ...............................................................................................15
16 Housing ..................... .................................... .................................................. ....................................
17 Utilities .................................................................................................................................................17
18 Other. Describe -
.11 1,682,463
.13
.16
18
19
)
If obligations are TANs or RANs, check only box I 9a ...................................................................10. LI
If obligations are BANs, check only box lOb ....................... ............ ............................................... - Li
If obligations are in the form of a lease or Installment sale, check box ..... ......... ............................ - LI
I1Tll I Description of Obligations. Complete for the entire issue for which this form is being fled.
(a) Final maturity date (b) Issue price price at maturity
21 7 /2018
(c) Stated redemption
aiage ty
Weighted (e) 'field
$ 1,682,463 $ 1,630,000 1.6679 years 2.5984%
I- Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued interest ....................................................................................................22 -01
23 Issue price of entire issue (enter amount from line 21, column (b)) ....................................................23 146L
24 Proceeds used for bond issuance costs (including underwriters' discount) 24 18,405
25 Proceeds used for crrxlit orihencernent ..........................................................25 1,113
26 Proceeds allocated to reasonably required reserve or replacement fund-, ... 26 0.
27 Proceeds used to currently refund prior issues .... .................... .... ..... ............. .27 1,662,945
28 Proceeds used to advance refund prior issues ........................ ...................... ..28 0
29 Total (add lines 24 through 28) ............................................................................................................29 1,682,463
30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) hhhhhhhhhhhhhhhhh30 0
Description of Refunded Bonds. Complete this part Lnly for,refunding bonds.
31 Enter the remaining weighted average maturity of the bonds to be currently refunded .... .... ............. IN- 1.5878 years
32 Enter the remaining weighted average maturity of the bonds to be advance refunded N/A years
33 Enter the last date on which the refunded bonds will be called (MMIDDIYYYY) .......... ........ ... .......... - 12105/2016
34 Enter the date(s) the refunded bonds were issued - (!'tMfoD/vr'Y) 01/31/2007
For Paperwork Reduction Act Notice, see separate instructions, cat. No, 63773S Form 8038-G (Rev. 92011)
Form 5036-C (Rev, 9-2011)
Page 2
kflhIYAI Miscellaneous
35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5)..................35 0
-
'Ga Enter the amount of gross proceeds invested or to be Invested in a guaranteed Investment contract
(GIC) (see instructions)... ..... ................ ..................... .. ......................... .............................................. .36a 0
b Enter the final maturity date of the GIC -
o Enter the name of the GIC 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 and enter the following information:
I, Enter the date of the master pool obligation - 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)(13)(i)(111) (small issuer exception), check box ........... ............ .- U
40 If the Issuer has elected to pay a penalty in lieu of arbitrage rebate, check box..................................................................
41a If the issuer has identified a hedge, check here to, LI and enter the following information:
b Name of hedge provider -
c Type of hedge L-
d Term of hedge -
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 ................................ ..........- LI
44 If the issuer has established written procedures to monitor the requirements of section 148, check box .........................'- UI
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 li.
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge
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
id
cignature process this return, to the parson that I have authorized above,
John Sweeney Ill, Chief Finance and Consent /')r L- Z5-11/03/2016 r Administrative Officer
Sigatf 're of Issuer's authorized repres1lve - Date - Type or print name and title
PrlfltlType preparer's name Prepareresignature Date I
ecic LI I PTIN Paid Darren C. McHugh iJii JIll03!2016 P01296493 Prepare Firm's name r
Use Only
- Stradling Yocca Carlson & Rauth, P.C. I Firm's EIN 95-3347002
Firma address - 1400 161`h Street, Suite 400, Denver, CO 60202 Phone no. (720) 616-6980
Form 8038-C (Rev, 9-2011)
M-2 IN Vs ri EMU LJ skyj V.11 I RI[(I
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-G relating to the issuance
of:
City and Borough of Sitka, Alaska
$1,630,000
General Obligation 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 2959),
Dated December 14, 2016.
Cynthia\\. Nevins
11200663-0019
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Complete items 1, 2, and S. A, Signature
Print your name and address on the reverse x 0 Agent
so that we can return the card to you. 0 Addressee
Attach this card to the back of the mailplece, B. Received by (Printed Name) C Date of Delivery
or_on_the front If space permits.
I Article Addressed to: D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below J No
Department of Treasury
Internal Revenue Set-vice Center
Ogden, UT 84201
3. Service 1'pe U Priority Mail ExpreasO 13 Adult Signature 0 Registered MSftSM
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0 Return Receipt for
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0 ArtirrIe IJr,mhar fFrcmnfr frmj'jjce label) 0 Collect on Delivery ]Restricted Delivery
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0 Signature ConfirmatienoM
0 Signeture Confirmation 7016 1970 0000 9940 2959 lat Restricted Delivery Restricteuoelivery
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USPS TRACKING #
11111111111111111111111111 11 11111111 1
9590 9402 2007 6123 4170 96
United States
Postal Service
Domestic Return Receipt
First-Class Mail
Postage & Fees Paid
lisps
111111 Permit No. G-10
Please print your name address, and ZlP+4 in this
Cynthia A. Nevins
Stradling Yocca Carlson & Rauth
800 Fifth Avenue, Suite 4100
Seattle, WA 9804