HomeMy WebLinkAboutA029 - IRS Form 8038-G Hall, Renee
From: Baker.Lauren@dorsey.com
Sent: Monday, August 22, 2022 12:07 PM
To: Hall, Renee
Cc: gerlachs@pfm.com; Pitcher, Duane;Wisecup, Roger; Nady, Kara; Geesman, Ashley;
Weiss, Neil; Dunn, John; Bjork.Amy@dorsey.com; Danos.John@dorsey.com;
ham mond.emily@dorsey.com; lemke.susan@DORSEY.com;
orngard.severie@dorsey.com; Regan.Erin@dorsey.com; ritter.cheryl@dorsey.com;
vaughtjessica@dorsey.com
Subject: IRS Filing Form 8038 (Ames #66)
Attachments: 8038-G (Ames #66 2022)-v1.pdf
[External Email]
Hello again, Renee,
Attached please find the IRS 8038-G filing form for the Water Revenue Bond. Federal law requires that this
special form be submitted in order to preserve the tax-exempt status of the interest earnings on the Bond.
Please print two copies, sign under the heading "Signature and Consent," and date it as of the date you sign
it. Then please scan and email a copy back to me and mail the original, executed copy to our office so that we
receive it as soon as possible. Retain one copy of the 8038 for the City's records.
Please feel free to contact me with any questions. Your courtesy, cooperation and attention are appreciated.
Have a great day! 0 4Z,��_
�C
Lauren BakerPublic Finance Finance Paralegal
DORSEY & WHITNEY LLP
8o1 Grand Avenue
Suite 4100 1 Des Moines,IA 50309
P:(515)699-3z84 F(515)864-0zo7
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Thank you.
Please help reduce paper and ink usage.Print only if necessary.
From: Baker, Lauren <Baker.Lauren @dorsey.com>
Sent: Monday, August 22, 2022 11:43 AM
To: Hall, Renee <renee.hall@cityofames.org>
Cc: gerlachs@pfm.com; Pitcher, Duane <duane.pitcher@cityofames.org>; Wisecup, Roger
1
<roger.wisecup@cityofames.org>; kara.nady@cityofames.org; ashley.geesman@cityofames.org; Weiss, Neil
<neil.weiss@cityofames.org>;john.dunn@cityofames.org; Bjork, Amy<Bjork.Amy@dorsey.com>; Baker, Lauren
<Baker.Lauren@dorsey.com>; Danos,John <Danos.John@dorsey.com>; Hammond, Emily
<hammond.emily@dorsey.com>; Lemke, Susan <lemke.susan@DORSEY.com>; Orngard, Severie
<orngard.severie@dorsey.com>; Regan, Erin <Regan.Erin@dorsey.com>; Ritter, Cheryl <ritter.cheryl@dorsey.com>;
Vaught, Jessica <vaught.jessica@dorsey.com>
Subject: SRF Closing Documents (Ames#66)
Good morning,
Attached please find the closing documents for the City of Ames's $3,500,000 Water Revenue Bond, Series
2022, dated August 26, 2022 for the City s records. Please review, and let us know if you have any
questions. We will be sending out an official transcript once we receive the fully executed documents back
from the Iowa Finance Authority.
Please note: If you have closed a bond market deal for which continuing disclosure was required on or after
Y g q
February 27, 2019, please note that you may be required to post a material event filing on the Municipal
Securities Rulemaking Board's EMMA website within 10 business days of the closing of this loan. Please
contact us if you would like to discuss this requirement.
Have a great day!
Lauren Baker
Public Finance Paralegal
C:) CD R S E Y.
DORSEY & WHITNEY LLP
8o1 Grand Avenue
Suite 4100 1 Des Moines,IA 50309
P:(515)699-3z84 F(515)864-0207
CONFIDENTIAL COMMUNICATION
E-mails from this firm normally contain confidential and privileged material,and are for the sole use of the intended recipient.
Use or distribution by an unintended recipient is prohibited,and may be a violation of law.If you believe that you received
this e-mail in error,please do not read this e-mail or any attached items. Please delete the e-mail and all attachments,
including any copies thereof,and inform the sender that you have deleted the e-mail,all attachments and any copies thereof.
Thank you.
Please help reduce paper and ink usage.Print only if necessary.
2
Ames/419370-66
Form t80384 Information Return for Tax-Exempt Governmental Bonds
(Rev.October 2021) ►Under Internal Revenue Code section 149(e) OMB No.1545-0047
►See separate instructions.
Department of the Treasury Caution:If the issue price is under$100,000,use Form 8038-GC.
Internal Revenue Service ►Go to www.irs.gov/F80380 for instructions and the latest information.
•. Reporting Authority Check box if Amended Return► ❑
1 Issuer's name 2 Issuer's employer identification number(EIN)
City of Ames,Iowa 42-6004218
3a 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 3a
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)
PO Box 811 3
6 City,town,or post office,state,and ZIP codery m i 7 Date of issue
Ames,Iowa 50010-0811 j August 26,2022
8 Name of issue w 9 CUSIP number
Water Revenue Bond Series 2022 _ 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 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 3,500,000
18 Other.Describe► 18
19a If bonds are TANS or RANs,check only box 19a > ❑
b If bonds are BANS,check only box 19b . . . . . . . . . . . . . . . . >s ❑
20 if bonds are in the form of a lease or installment sale,check box . 1' ❑
Description of Bonds. Complete for the entire issue for which this form is being filed.
(a)Final maturity date (b)Issue price (c)Stated redemption (d)Weighted (a)Yield
price at maturity average maturity
-_,_,,,....
21 06/01/2042 $ 3,500,000 $ 3,500 000' 10.922 years 1.7501 %
•: Uses of Proceeds of Bond Issue(including underwriters'discount)
22 Proceeds used for accrued interest _.,,_
23 Issue price of entire issue(enter amount from line 21,column(b)) . . . 23 1 3,500,000
24 Proceeds used for bond issuance costs(including underwriters'discount) 24 1 17,500
25 Proceeds used for credit enhancement 25
26 Proceeds allocated to reasonably required reserve or replacement fund 26
27 Proceeds used to refund prior tax-exempt bonds.Complete Part V . . i
28 Proceeds used to refund prior taxable bonds.Complete Part V . . . . 28
29 Total(add lines 24 through 28) , . . . . . . . . . . . . . . . . . . . 29 17,500
30 Nonrefunding proceeds of the issue(subtract line 29 from line 23 and enter amount here) 30 3,482,500
TO. Description of Refunded Bonds.Complete this part only for refunding bonds.
31 Enter the remaining weighted average maturity of the tax-exempt bonds to be refunded . . . ► years
32 Enter the remaining weighted average maturity of the taxable bonds to be refunded . . . . ► years
33 Enter the last date on which the refunded tax-exempt bonds will be called(MM/DD/Y),YY) ►
34 Enter the date(s)the refunded bonds were issued►(MM/DD/YYyY)
For Paperwork Reduction Act Notice,see separate instructions. Cat.No.63773S Form 8038-G(Rev.10-2021)
Form 8038-G(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
(GIC).See instructions . . . . . . . . . . . . . . . . . . . . . . 36a
b Enter the final maturity date of the GIC►(MM/DD/YYYY)
c Enter the name of the GIC 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
38a If this issue is a loan made from the proceeds of another tax-exempt issue,check box► 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 I_ _
39 if the issuer has designated the issue under section 265(b)(3)(I3)(i)(III)(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►
c Type of hedge► µ _
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► ❑✓ and enter the amount
of reimbursement . , ► $161,810.47
b Enter the date the official intent was adopted►(MM/DD/YYYY) 0 512 412 02 2
Under perigies of perjury,I declare that I have examined this return and accompanying schedules and statements,and to the best of my knowledge
Signature and ,t ey are true,correct,an complete.I further declare that I consent to the IRS's disclosure of the issuer's return information,as necessary to
9 pro s i return,to the pers at I have a orized above.
and Y_4�
Consent U _Renee Hall City Clerk
Signat a of issuer's authorized representative Date r Type or print name and title
Paid Print/Type preparer's name Preparer's sipature Date Check ❑ if PTIN
Preparer John P.Danos � --- [P� • self-employed P01083460_._ �_ -
Use Only Firm'sname ►Dorsey&Whitney LLP Firm's EIN> 41-0223337_Firm's address►801 Grand Avenue,Suite 4100,Des Moines,Iowa 50309 Phone no. 515-283.1000
Form 8038-G(Rev.10-2021)
SCHEDULEI
TO
8038-G
City of Ames,Iowa
Water Revenue Bond, Series 2022
EIN: 42-6004218
PART VI, Line 38d
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 EIN of the Iowa Finance Authority is 52-1699886.
4895-4084-1262\1