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Tab 27 IRS Form 8038-GFom 809M,.8—u (Rev. May 1999) ' Department of the Treasury Internal Revenue Service Information Return for Tax -Exempt Governmental obligations ■ Under Internal Revenue Code section 149(e) ■ See separate Instructions. Caution: Use Form 8038-GC if the issue price is under $100,000. OMB No. 1545-0720 I1, RM M Reoortina Authority If Amended Return. check here ► n I issuer's name 2 Issuer's employer Identification number KALISPELL CITY OF MONTANA 81-6001281 3 Number and street (or P.O. box if mail is not delivered to street address) Room/suite 4 Report number 312 FIRST AVENUE EAST G 2001- 5 City, town, or post office, state, and ZIP code 6 Date of issue KALISPELL MT 59903 JUNE-129 2001 7 Name of issue 8 CUSIP number SPECIAL IMPROVEMENT DISTRICT NO.343 BONDS 48342Q AV0 9 Name and title of officer or legal representative whom the IRS may call for more information 10 Telephone number of officer or legal representative AMY ROBERTSON FINANCE DIRECTOR 406 758-7701 .. P Type of Issue (check applicable box(es) and enter the issue price) See instructions and attach schedule 11 ❑ Education.................................................................. 12 ❑ Health and hospital ................. ........................ ............ 13 ❑ Transportation ........ ............. ■........................................ 14 El Public safety................................................................ 15 El Environment (including sewage bonds) ............................................ 16 El Housing................................................................... 17 Ej Utilities.................................................................... 18 Other. describe ■ street and utility improvements '.v..s':.ti';: 19 If obligations a ions are e TANs or RANs check box If obligations r B N are BANs, check box ...... '.`.-=:a>':;�:w:e,::-::<.✓�r�•r.-x�:�a�:�r.:2:.:�.,.;.�<�. 20 If obligations are in the form of a lease or installment sale check box ... ... ..... ❑2 11 12 13 14 15 16 17 18 1,5813500 �?;+. ...�rx�.,''.�'wy... "•":/.^';:v ...:r � _ - =� �. :. ,Mr� .:� ".------------------ f' r Description of obligations. (Complete for the entire issue for which this form is being filed.) (a) Final maturity date (b) Issue price (c) Stated redemption price at maturity (d) Weighted average maturity (e) Yield 21 711121 is 1 581 500 $ 1 581 500 1 10.645 years 5.05196 % -P .s 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)} .......................... 24 Proceeds used for bond issuance costs (including underwriters' discount) 24 51 778.57 25 Proceeds used for credit enhancement ........................... 25 26 Proceeds allocated to reasonably required reserve or replacement fund .. 25 27 Proceeds used to currently refund prior issues ..................... 27 0 28 Proceeds used to advance refund prior issues ..................... 28 j` Jj 29 Total (add lines 24 through 28) .................................................... 30 Nonrefunding proceeds of the issue (s ct a 29 from line 23 and enter amount here) ........ 22 2312.49 23 1,581,500. u ::. xF,: g.:.. k= = V,.... 51 778.57 29 30 1,529,721.43 - Description of Ref n omplete this part only for refunding bonds.} 31 Enter the remaining w ' i;Aaturh the bonds to be currently refunded ........... ■ years 32 Enter the remaini M_weig average rn he bonds to be advance refunded ........... ■ years 33 Enter the last date n Ich the ref nd be called ............................ ■ 34 Enter the date(s)th r nde d were J8 ed ■ 35 Enter the amount of th stye t- ocated to the issue under section 14'1(b)(5) ......... 35 0 36a Enter the amount of gross pro s i or to be invested in a guaranteed investment contract (see instructions) ... ■ 36a 0 b Enter the final maturity d f the guaranteed investment contract ■ =gz r. 37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other governmental units ........... 37a 0 b If this issue is a loan made from the proceeds of another tax-exempt issue, check box ■ 1:1 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)(Ill) (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 and belief, Please they are t e correct and pomplete. WILLIAM BOHARSKI Sign d �- MAYOR Here Signature of issuer's authorized representative IDate Tvoe or print name and title For Paperwork Reduction Act Notice, see page 2 of the Instructions. ISA STF FED6403F Form 8038-G (Rev 5-99) DORSEY & WHITNEY LLP MINNEAPOLIS NEW YORK SEATTLE DENVER WASHINGTON, D.C. DES MOINES ANCHORAGE LONDON COSTA MESA CERTIFIED MAIL RETURN RECEIPT REQUESTED Internal Revenue Service Ogden, UT 84201 MILLENIUM BUILDING BILLINGS 125 BANK STREET, SUITE 600 GREAT FALLS MISSOULA, MONTANA 59802 MISSOULA TELEPHONE: (406) 72 .---6025 BRUSSELS FAX: (406) 543-0863 FARGO MAE NAN ELLINGSON HONG KONG ellings vn.mae.nara dvrs eylaw.c vm RC7CHESTER SALT LAKE CITY VANCOUVER June 19, 2001 RE: $11581,500 Special Improvement District No. 343 Bands City of Kalispell, Montana Dear Sir/Madam: Enclosed are two 8 03 8 - G's, Information Return for Tax --Exempt Governmental Obligations, filed pursuant to Section 149(e) of the Internal Revenue Code with respect to the issuance of the Issuer's bonds. Please file one copy of the enclosed Form 8038-G and acknowledge receipt by signing and dating the enclosed duplicate thereof and returning to the undersigned. Very truly yours, Mae Nan Ellingson MNEIj kh Enclosure