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HomeMy WebLinkAboutA035 - Information Return for Tax-Exempt Governmental Obligation, Form 8038-G, , 9J7043 ` Form8038-G Information Return for Tax -Exempt Governmental Obl 6 0- Under Internal Revenue Code section 149(e) (Rev. May 2010) 10- See separate instructions. Depart rient of the freasury lnterna� Revenue Service Caution: If the issue price is under $100,000, use Forrn 8038-GC. IT -MI Reoorhno Aothorhv If Amended Retunn, check here P, LJ 1 Issuer's name 2 Issuer's employer identification number (EIN) City of Ames, Iowa : 6004218 3 Number arid street (or R0. box if mail is riot delivered to street address) Room/SUite ­42 4 Report number (For IRS Use Only) 515 Clark Avenue 5 City, town, or post office, state, and ZIP code 6 Date of issue 7 Name of issue 8 CUSIP number General Obligation Corporate Purpose Bonds, Series 2010A 030807 H 20 9 Name and title of officer of the issuer or other person whom the IRS may call for more information 10 Telephone number of officer or other persor Robert E. Josten I Dorsey & Whitney ILLP Bond Counsel 515 283-1000 18 Other. Describe 0, improvements to streets, bridqes_,0ty Hall,_ acquisition of fire equip If obligations are BANS, check only box 19b . . . . . . . . . 20 If obligations are in the form of a lease or installment sale, check box . . . . . . DescriDtion of Obligations. Complete for the entire issue for which this form is bei filed. (a) Final maturity date (b) Issue price Stated redemption price at maturity (d) Weighted average maturity (e) Yield underwriters' discou.ni 24 Proceeds used for bond issuance costs (including underwriters' discount) 24 77,888 75 25 Proceeds used for credit enhancement . . . . . . . . . . 25 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 MIR"',Aff 30 6, 7 0 5, 0:3 0=4 30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) Description of Refunded Bonds (Comp ete 31 Enter the remaining weighted average maturity of the bonds to be currently refunded . . . 0° 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 <K4M/DD/YYYY . . . . . w~ 34 Enter the date(s) the refunded bonds were issued lo(MM/DD/YYYY) For Privacy Act and Paperwork Reduction Act Notice' see separate instructions. Cat. No. *nnae Form 8038-G (Re«s-2u/m Form 8038-G (Rev. 5-2010) Page 2 f7r,M Miscellaneous 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 (GIC) (see instructions) . . . . . . . . . . . . . . . . . . . . . 36a -7717"- b Enter the final maturity date of the GIC ► 37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units . . . . . . . . . . . . . . . . . . . . . . . . . 37 b If this issue is a loan made from the proceeds of another tax-exempt issue, check box 0i ❑ and enter the name of the issuer ► and the date of the issue 0i 38 If the issuer has designated the issue under section 265(b)(3)(B)(i)(Ill) (small issuer exception), check box . . . . ► 0 39 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . . . . . . . . . . . ► ❑ 40 If the issuer has identified a hedge, check box . . . . . . . . . . . . . . . . . . . . . . . ❑ Under penalties of perjury, 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 process thi return, to tt erson that I have authorized above. and Consent Diane R. Voss, qJtv Clerk Signature of issue ' uthorized representative Date Type or print name . aria titie 4- 1 Date, Preparer's SSN or PTIN Preparer's Check if Paid t. gnature self em loved ❑ P01075995 'g Preparers a] -LIUQ4, s Firm's na, e or DVrse—y & Whitney ILL FIN 41 :0223337 use Only vours if s If-.mpl ed), 283-1000 Z co d address, Z od/ 8* Grand, Suite 3900, Des Moines, [A 50309 11hone no. (515) Form 8038-G (Rev. 5-2010)