Tab_272Internal Revenue Service
Ogden, Utah 84201
Onick, Herrinqton & Sutchk LIP
701 5th Avenue
Suite 5600
$eette, WA 981047097
+1 206 839 4300
orrick corn
tmakensorrick,com
D +1206 839 4347
F +12068394301
Re: Information Return for Tax-Exempt Governmental Obligations Alaska Municipal Bond Bank
General Obligation and Refunding Bonds, 2016 Series Three and 2016 Series Four
Ir Ii
1:111NINT-MMARM77 on ma. IM
iliTh.Tsfl
Very truly yours,
Trudie Makeis
li U
- ions
flIIL1IL 1> See separate instructions.
lr Under Internal Revenue Code section 149(e) OMB No. 1545-0720
Caution. If the issue price is under $100,000, useFbrm8038-GC,
isuer7a employer Identification number (EIN)
Z 92-6001185
39 Name of person (other than anuer) with whom the IRS may communicate about this return (See umructlona) number of other person shown on Se
4 Number and street (or P.O boa It melt Is not delivered to street address) Room/scAle C Report number (For IRS Use UY)
333 Willoughby Avenue 11th Floor L]
a City, town, or post office, state and ZIP coda 7 Date of tarwe
Juneau Alaska 99801-0405 11/03/2016
S Name of issue 9 CUSP 'urnber
General Obligation and Refunding Bonds, 2016 Series Three and 2016 Series Four 01179RTE3
iCe Name and title of officer or other employee at the Issuer whom the AS may call for more Information (see lOb Telephone number at officer or other
Instructions) employee shown on be
Deven J. Mitchell, Executive Director 907465.3750
7ype of Issue (enter the issue pr(ce), See the instructions and attach schedule,
11 Education
12 Health and hospital
13 Transportation ............................
14 Public safety .............................
15 Environment (including sewage bonds) ....................
16 Housing
17 Utilities ..............................
__________
15 Other. Describe Loans to Governmental Units
16 If obligations are TANS or RAN s, check only box 19a .............th' 0
If obligations are BANS, check only box 19b ................kc 0
0 If obligations are in the form of a lease or Installment sale, check box ........k 0
(c) Stated redemption
price at maturity t
(d) Weighted
average maturly
-dIi
pktm~ W-1
g underwriters' discount)
H • 1
___
•
8038-G (Rev. 9.2011) Page 2
Miscellaneous
L_ Enie-r -the amount of the state volume cap allocated to the issue under section 141(b)(5) 35 0 00
36 Enter the amount of gross proceeds invested or to be Invested in a guaranteed investment contract
b Enter the final maturity date of the GIC 11;~
issue
Form
c, Enter the name of the GIC provider f>
37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans
38a It this is a loan made from '
b Enter a date of the master
Ii C Enter the EIN of the
d Enter the name of the Issuer of the master pool obligation lit,
39 It the Issuer has designated the Issue under section 265(b)(3)(B)(i)(Ill) (small issuer exception), check box . . . . 0
40 It the
I
arbitrage
41a If the enter the following information:
b Name of hedge provider 10-
c Type of hedge D>
d Term of hedge 0-
43 if the Issuer has established written procedures to ensure that all nonquatifled bonds of this issue are remediated
according to the requirements under the Code and Regulations (see instructions), check box . . . . . . . .
issuer has established written procedures to monitor the I1the requirements
If I tfL
box
JpJ!iI I
b Enter the date the official
Under pwrVee of perjury. Signature and ellaf, are true/
and pr eas7ratumt,
Consent K, I
e examined this return and accompanyng schedules and statements, and to the best of my knowledge
fe further declare that I consent to the IRS's ci actosure of the Issuer's return Information, as necessary to
authorized above.
11/03/2010
Deven J. Mitchell, Executive Director
Paid Print
cot
/ty a preparer's name
)rep So
Sutcliffe LLP Use On ly
Schickli, Esq. ___j -
!Irm'e n me Orrick, Herrington &
Firm's a ddress a 1120 NW Couch Street, Suite 200, Portland, OR 97209
Type or print name and title
Ve Check DI1PT IN
self-employed P01499071
frm's EIN 01, 942952627
Phone no. 5034434830
] ITIT It
From: TrackingUpdates@fedex.com
Sent: Tuesday, November 29, 2016 8:49 AM
To: Makens, Trudie
Subject: FedEx Shipment 777808405988 Delivered
Your package has been delivered
Tracking # 777808405988
Ship date: Delivery date:
Mon, 11/28/2016 Tue, 11/29/2016 9:43
ueMakens am
Orrick, Herrington & Sutcliffe Internal Revenue Service
Seattle, WA 98104 Center
US Internal Revenue Service
Delivered Internal Revenue Service
Center
INTERNAL REVENUE
SERVICE UT 84201
US
Shipment Facts
Our records indicate that the following package has been delivered.
Tracking number: 777808405988
status: Delivered: 11/29/2016 09:43
AM Signed for By: D.LIZZA
Reference: 33401.8
Signed for by: D.LIZZA
Delivery location: INTERNAL REVENUE
SERVICE, UT
Delivered to: Shipping/Receiving
eMce type: FedEx Priority Overnight
Packaging type: FedEx Envelope
;lumber of pieces:
:eight: 0.50 lb.
:peciai handling/Services: Deliver Weekday
Standard transit: 11/29/2016 by 10:30 am
1
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