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Home My WebLink AboutA030 - IRS Form 8038-G dated May 17, 2011 r 1 '7 419370-45 -7 8®�� Information Return for Tax-Exempt Governmental Obligatrvns - Form ► Under Internal Revenue Code section 149(e) OMB No.1545 0720 (Rev.May 2010) ► See separate instructions. Department of the Treasury Internal Revenue Service Caution:If the issue price is under$100,000, use Form 8038-GC. porting Authority If Amended Return, check here ► ❑ 1 Issuer's name 2 Issuer's employer identification number(EIN) City of Ames, Iowa 42 ; 6004218 3 Number and street(or P.O.box if mail is not delivered to street address) Room/suite 4 Report number(For IRS Use Only) 515 Clark Avenue 3 5 City,town,or post office,state,and ZIP code 6 Date of issue Ames, Iowa 50010-0811 May 17,2011 7 Name of issue 8 CUSIP number General Obligation Refunding Bonds,Series 2011A 030807 J44 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 person Robert E.Josten/Dorsey&WhitneyLLP Bond Counsel ( 515 ) 283-1000 FTM Type of Issue (enter the issue price)See instructions and attach schedule 11 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Health and hospital . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 Public safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 15 Environment (including sewage bonds). . . . . . . . . . . . . . . . 15 16 Housing . . . . . . . . . . . . . . . . . . . . . . 16 17 Utilities . . . . . . . . . . . 17 18 Other. Describe► refunding 18 1 6,084,540 19 If obligations are TANS or RANs, check only box 19a . . . . . . . . . . . . ► ❑ If obligations are BANS, check only box 19b . . . . . . . . . . . . . . . ► ❑ 20 If obligations are in the form of a lease or installment sale, check box . . . . . . . ► ❑ Description of Obligations. Complete for the entire issue for which this form is being filed. :21June inal maturity date (b)Issue price (c)Stated redemption (d)Weighted (e)Yield price at maturity average maturity 1,2021 $ 6,084,540 $ 5,980,000 3.5887 vears 1.9254 % Uses of Proceeds of Bond Issue (including underwriters' discount 22 Proceeds used for accrued interest. . . . . . . . . . . . . . . . . . 22 23 Issue price of entire issue(enter amount from line 21, column (b)) . 23 6,084,540 24 Proceeds used for bond issuance costs(including underwriters' discount) . 24 59,984 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 6,020,000 28 Proceeds used to advance refund prior issues . . . . . . . . . 28 29 Total (add lines 24 through 28) . . . , . . . . 29 6,079,984 30 Nonrefundin roceeds of the issue subtract line 29 from line 23 and enter amount here 30 4,556 Description of Refunded Bonds (Complete this part only for refunding bonds.) 31 Enter the remaining weighted average maturity of the bonds to be currently refunded. . . ► See attached 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) . . . . . ► 06/01/2011 34 Enter the date(s)the refunded bonds were issued ►(MM/DD/YYYY) See attached For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat.No.63773S Form 8038-G (Rev.5-2010) Form 8038-G(Rev.5-2010) Page 2 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 _,i%, (GIC)(see instructions) . . . . . . . . . . . . . . . . . . . . . . . . . 36a 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 N211m governmental units . . . . . . . . . . . . . . . . . . . . . . . . . . 37a b If this issue is a loan made from the proceeds of another tax-exempt issue, check box►❑ and enter the name of the issuer ► and the date of the issue ► 38 If the issuer has designated the issue under section 265(b)(3)(B)(i)(III) (small issuer exception), check box . . . . ► ❑ 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 and Z;N s return,to a on t at I have authorized above. Consent -511y/// Diane R.Voss,City Clerk IF Signature of igs is a horized representative Date ' Type or print name and title Paid Preparer's �D^hiate Check if Preparer's SSN or KIN signature ' 5 - J — I I self-employed❑ P01075995 Preparers Firm's name(or Use Only yours if self- mploye ey&Whitney LLP EIN 41 0223337 address,an ZIP cc e' , 8 1 Grand,Suite 3900,Des Moines,IA 50309 Phone no. (515) 283-1000 Form 8038-G (Rev.5-2010) ATTACHMENT TO 8038-G City of Ames, Iowa 42-6004218 Issue Date: May 17, 2011 Part V 31. (a) 5.9208 years; (b) 2.0652 years; (c) 2.5381 years 34. (a) 05/01/2002; (b) 10/15/2002; (c) 09/03/2003