HomeMy WebLinkAboutA071 - Form 8038-G dated August 18, 2023 I
I
Ames 1419370.74
Form8038—G information Return for Tax-Exempt Governmental Bonds
►Under Internal Revenue Code section 149(e)
(Rev.October 2021) ►See separate Instructions. OMB No.1546-0047
Department of the Treasury Caution:I1 the Issue price Is under$100,000,use Form 8038-0C.
Internal Revenue Service ►Go to www.irs.gov/F80380 for Instructions and the latest information.
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Reporting Authority Chk box If Amended Return 0- 0
1 Issuer's name 2 Issuer's employer Identification number(EIN)
Cit of Ames,Iowa
42.6004218
..Y
e of person other than Issue with whom the IRS may communicate about this return(see Instructions) 3b Telephone number of other person shown on 3a
•� 3a Nam Po ( 1
4 Number and street(at P.O,box If mail Is not delivered to street address) Room/suite 5 Report number(Far IRS Use Only)
PO Box 811 3 -7
6 Clty,town,or post office,state,and ZIP code 7 Date of Issue
Ames, Iowa 50010.0811 08/1812023
8 Name of Issue 9 CUSIP number
Sewer Revenue Bond, Series 2023C NONE
10a Name and title of officer or other employee of the Issuer whom the IRS may call for more Information 10b Telephone number of officer or other
employee shown on 10a
Renee Hall, City Clerk (515) 239-5105
- . Type of Issue(Enter the issue price) See the instructions and attach schedule.
11 Educatlon . . . . . . . . . . . . . . . . . . . . . . . . . . ... 11
12 Health and hospital . . . . . . . . . . . . • . . • . , . . 12 .
13 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 w
14 Public safety . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
15 Environment(Including sewage bonds) . . . . . . . . . . . . . . . . . . . • 15
16 Housing . . . . . . . . . . . . . . . . . . . . . . . 16
17 Utilities . . , . . . . . . . . . . . . . . . . . . . . 17 2,150,000
18 Other, Describes 18
19a If bonds are TANS or RAl check only box 19a . . , . . , . . . . , ►
b If bonds are BANS,check only box 19b , . , . . . . . . . . . . . . . ► ❑ r
20 If bonds are In the form of a lease or installment Salo,check box . ► ❑
rM Description of Bonds. Complete for the entire Issue for which this form Is beln Tiled,
(c)Slated redemption (d)Weightetl (e)YlaId
(a)Final maturity date (b)Issue price price at maturity average maturity
21 �06/01/2043 $ 2,150,000 $ 2,150,000 11.373 years 1,7501
Uses of Proceeds of Bond Issue (including underwriters' discount)
22 Proceeds used for accrued Interest . . . . . . . . . . . . . . 22 _ 0
23 Issue price of entire Issue(enter amount from line 21,column (b)) . . . . . • 23 2,150,000
24 Proceeds used for bond Issuance costs(Including underwriters' discount) 24 10,750
25 Proceeds used for credit enhancement , . . . . . . , . . 25 0
26 Proceeds allocated to reasonably required reserve or replacement fund 26 0
27 Proceeds used to refund prior tax-exempt bonds, Complete Part V . . . 27 0
28 Proceeds used to refund prior taxable bonds. Complete Part V 28 0 "l
29 Total(add lines 24 through 28) . . . . . . . . . 29 110,750
30 Norrefunding proceeds of the issue(subtract line 29 from line 23 and enter amount here) 30 2,139,250
Description of Refunded Bonds, Complete this pa t only for refunding bonds.
31 Enter the remaining weighted average maturity of the tax-exempt bonds to be refunded . . . I► years
32 Enter the remaining weighted average maturity of the taxable bonds to be refunded . . . . s years
33 Enter the last date on which the refunded tax-exempt bonds will be called(MM/DD/YYYY) ► �,
34 Enter the dates)the refunded bonds were Issued►(MM/DD/YYYY)
For Paperwork Reduction Act Notice,see separate instructions. Cat.No,637/3S Form 8038-G(Rev.10-2021)
Form 8038-Q(Rev.10-2021) 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 _
(GIG).See Instructions . . . . . . . . . . . . . . . . . . . . . . . . . 36a
b Enter lne final maturity date of the GIC P (MM/DD/YYYY)
c Enter the name of the GIG provider V
37 Pooled financings: Enter the amount of the proceeds of this Issue that are to be used to make leans
to other governmental units . . . . . . . . . . . . . . . . . . 37
38a If this Issue is a loan made from the proceeds of another tax-exempt issue,check box► M and enter the following Information:
b Enter the date of the master pool bond►(MM/DD/YYYY)
c Enter the EIN of the Issuer of the master pool bond►
d Enter the name of the Issuer of the master pool bond► See attached Schedule 1
39 If the Issuer has designated the issue under section 265(b)(3)(B)(i)(111)(small Issuer exception), check box . . , , ► ❑
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► ❑ and enter the following Information:
b Name of hedge provider i
c Type of hedge 0-
d Term of hedge
42 . If the Issuer has superintegrated the hedge, check box . . . . . . . . . . . . . . . . . . . ► ❑
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 . . . . . . , , ` ❑✓
44 If the Issuer has established written procedures to monitor the requirements of section 148,check box . . . . . ► ❑✓,
45a If some portion of the proceeds was used to reimburse expenditures,check here► 1]and enter the amount
of reimbursement . . . . . ► $79,165.43
b Enter the date the official intent was adopted►(MM/DD/YYYY) o6127123
Under enalties of perjury,I decla that I have examined(his return and accompanying schedules and statements,and to the best of my knowledge
Signature and b el,t y are true,correct nd complete. further declare that I consent to the IRS's disclosure of the Issuer's return information,as necessary to
prat thl , turn,to the p that have authorized above.
and — 0
Consent / __ 1 1 Renee Hall, City Clerk
01.- Isauer s authorzed representative Date Type or print name and'titlo
Paid PrinVrype preparer's name Prep re Date Check ❑ If PTIN
John P. Danes -" ,.a self-employed PD1083460
PYepaYeY Flrm'sname ►Dorsey&WhitneyLLP Run'sEIN► 41.0223337
Use Only Plrm'sad Grand Avenue,suite 4100,Des Molnos Iowa 50309 Phone no. 515.283.1000
Form 8038-G(Rev,1 s-2021)
SCHEDULE
TO
8038-G
i
City of Ames, Iowa
Sewer Revenue Bond, Series 2023C
EIN: 42-6004218
PART VI, Line 38d
I
The Iowa Finance Authority (the "Authority") is the bondholder with respect to the above
referenced bonds. The Authority may determine in the future to issue tax-exempt bonds that are
master pool obligations and reimburse itself for the loan of the proceeds of the above referenced
bonds. To the extent that the Authority issues such master pool obligations and reimburses itself
from the proceeds of such master pool obligations for the loan of the proceeds of the above
referenced bonds, such reimbursement will be made on the date of issue of such master pool
obligations,
The FIN of the Iowa Finance Authority is 52-1699886.
4877-2645-7461\1