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Tab_261C Form C (Rev. September 2011) Department of the Treasury r,trn'.I °evenue Service Reporti I nformation Return for Tax-Exempt Governmental Obligat ions Under Internal Revenue Code section 149(e) See separate instructions. Caution: If the issue price is under$100,000, use Form 8038-GC. If Amended Eteturn. check here 0MB No. 1545-0720 1 Issuer's name 2 Issuers employer identification number (E IN) City of Wasilla 92-6010143 35 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 Sa 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) 290 East Herning Avenue ________________ 6 City, town, or post office, state, and ZIP code 7 Date of issue Wasifla, Alaska 99654 November 8, 2016 8 Name of issue B CUSIP number General Obligation Refunding l3oncl, 2016 Series A None 105 Name and title of officer or other employee of the issuer whom the IRS may call for more information (see 1013 Telephone number of officer or other instructions) employee shown on 1 Os Troy Tankersley, Finance Director 907.373.9090 - I I I I ype or issue enter me issue price). See the instructions and attach schedule. 11 12 13 14 15 16 17 18 Education ..........,.,,,,,,,,,,,,,,,,,, Health and hospital .......,..,,,,,.,,,,,,,,,, Transportation ..................................13 Public safety ................................14 Environment (including sewage bonds) ............................15 Housing ................................... Utilities ..,.......,.,.,.,..,,.,,,,,,, Other, Describe ii 12 841,231 19 20 lf obligations are TANS orRANs, check only box l9a .............. Li If obligations are BANS, check only box 19b .................. LI If obligations are in the form of a lease or installment sale, check box .,...,,, 10. LI _ IDescription of Obligations Compte for he entire Issue for whh this form is being filed, (a) Final maturity date r (13) Issue price (c) Stated tion (d) aaige haty ted (e) Yield 21 I 12/01/2018 1 $ 841,2311 015,0001, 1.5679 ears 2.5985 % 0 1 Uses of Proceeds of Bond issue (including underwriters' discount) 22 0 23 Proceeds used for accrued interest ...........................22 Issue price of entire issue (enter amount from line 21, column (b)) . ............. 23 841,231 24 Proceeds used for bond issuance costs (including underwriters' discount) 24 8,295 25 26 Proceeds allocated to reasonably required reserve or replacement fund 26 0 27 Proceeds used for credit enhancement .............25 557 28 Proceeds used to currently refund prior issues ..........27 828,898 Proceeds used to advance refund prior issues ..........28 0 29 837,750 30 Total (add lines 24 through 28) ..........................29 N. irefunding proceeds of the issue (subtract line 29 from line - . . 23 and enter amount here) 30 3,482 I Description of Refunded Bonds. Complete this part only for ref(indli-ig bonds. al 32 33 Enter the remaining weighted average maturity of the bonds to be currently refunded . - . ,js~ 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/DDI'Y'YYY) ..,,,.111~ 1.5891 years years 12/05/2016 34 Enter the date(F) the refunded bonds were issued (MM/DD/Y)YY) 01/3112007 For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 63773S Form 8038.G (Rev. 9-2011) Fnrm 8038-0 (Rev. 9-2011) Page 2 1LL' Miscellaneous 35 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) . . . 35 0 36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (GIG) (see instructions) ............................0 b Enter the final maturity date of the GIC P, o 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 1 0 = 38a If this issue is a loan made from the proceeds of another tax-exempt issue, check box 0, Z and enter the following information: b Enter the date of the master pool obligation November 3, 2016 o Enter the EIN of the issuer of the master pool obligation Po, 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)(1I1) (small issuer exception), check box . .. , - El 40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box ............. El 41a If the issuer has identified a hedge, check here - El and enter the following information: b Name of hedge provider Pi- 0 Type of hedge t- d Term ofhedge 42 If the issuer has superintegrated the hedge, check box ......................El 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 ........ 10, El 44 If the issuer has established written procedures to monitor the requirements of section 148, check box ..... El 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 peliury, 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, rc t, and Ifurther declare that I consent to the IRS's disclosure of the issuer's return information, as necessary to and process thisreturn u-pd canes. Consent Troy Tankrsley, Finance Director Signature of issuer su ee, Date's Print/Type preparer's name , ;r sqciuiJJ - Tyne or print name and title Date -. , check Plil ' Pad Preparer - . Thomas Klinkner .11 I 1 4 1 ' ' self-employed' P01874546 - Use Only Firm's name birch Horton Bittner d Firm's—------ ---. Firm's address 1127 West 7th Avenue, Anchorage AK 99501 Phr'no, 901.263.1219 Form 8038-G (Rev. 9-2011) Birch Horton Bittner & Cherot a professional corporaEioo Thomas F. Klinkner Respond to Anchorage Office T 907.263.7219 • F 907.276.3680 tklinkner@bhb.com November 8, 2016 AMU[ 'I!! I1 :1111 1I i 4I1 i I Department of the Treasury Internal Revenue Service Center Ogden, UT 84201-0074 RE: City of WasiUa, Alaska Our File No.: 505,780.158 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 [ ] For review and comment [ ) Return to our office 1] Returned to you [] Forward to: Please call Tom Klinkner at (907) 276-1550, if you have any questions. Yours truly, TFK:lcj Enclosure j k . Thomas F. Klinkner 1127 West Seventh Ave. Anchorage AK 99501-3301 1156 15th St. NW., Ste. 1020, Washington, D.C. 20005-1754 T 907,276.1550 800.478.1550W F 907.276.3680 1 T 202.659.5800 • F 202.659.1027 505780\1 58\00558117 LAW OFFICES BIRCH HORTON BFFTNER&CHEROT A PROFESSIONAL CORPORAT I ON 1127 WEST SEVENTH AVENUE ANCHORAGE ALASKA 99501 505,780.158 91 710 2133 3937 2497 3846 DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE CENTER OGDEN LIT 84201-0074 Linda Julian - From: auto-reply©usps.com Sent: Monday, November 14, 2016 9:12 AM To: Linda Julian Subject: USPS item Delivered, To Agent for Shipment 9171082133393724973846 Tracking Number: 9171082133393724973846 Hello Linda Julian, Thank you for using USPScom. 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 N umber: 9171082133393724973846 Expected Delivery Date: November 14, 2016 Service Type: Certified MailTM Shipment Activity Location Shipping Date & Time Partner Delivered, To Agent OGDEN, UT 84201 November 14, 2016 10:20 am In Transit to Destination November 11, 11:47 pm SALT LAKE CITY, UT Departed USPS Facility November 10, 84199 2016 10:53 pm SALT LAKE CITY, UT Arrived at Unit 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, 1 Departed Post Office ANCHORAGE, AK 99517 Acceptance ANCHORAGE, AK 99517 2016 9:50 pm November 8, 2016 6:20 pm 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 Date of Request shown above. 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