Tab 20 IRS Form 8038-GG O R S E Y"
TRICIA C. ELPEL, Paralegal
elpel.tricia@dorsey.com
June 2, 2014
CERTIFIED MAIL
RETURN RECEIPT REQUESTED
Internal Revenue Service
Ogden, UT 84201
Re: $$242,000 Special Improvement District No. 345 Bond (DNRC Water Pollution
Control State Revolving Loan Program), Series 2014
City of Kalispell, Montana
Dear Sir/Madam:
Enclosed is an IRS Form 8038-G, Information Return for Tax -Exempt Governmental
Obligations, for the above -referenced City, to be filed pursuant to Section 149(e) of the Internal
Revenue Code with respect to the issuance of the City's bonds.
Please file the enclosed Form 8038-G. Thank you.
Enclosures
Very truly yours, yy }
Tricia C. Elpel, Paralegal
DORSEY & WHITNEY LLP ^ WWW.DORSEY.COM • T 406.721.6025 • F 406.543.0863
MILLENNIUM BUILDING ° 125 BANK STREET • SUITE 600 ^ MISSOULA, MONTANA 59802-4407
USA CANA[DA EUROPE ASIA-PA, C I P IC
Form 8038-G
(Rev. September 2011)
Department of the Treasury
Internal Revenue Service
Information Return for Tax -Exempt Governmental Obligations
► Under Internal Revenue Code section 149(e) OMB No. 1545-0720
► See separate instructions.
Caution: If the issue price is under $100,000, use Form 8038-GC.
EtMEM Rpnnrtina Authoritv If Amended Return, check here ► LJ
1 Issuer's name
2 Issuer's employer identification number (EIN)
City of Kalispell, Montana
81-6001281
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)
P.O. Box 1997
3 rM
6 City, town, or post office, state, and ZIP code
7 Date of issue
Kalispell, MT 59903
May 15, 2014
8 Name of issue
9 CUSIP number
Special Improvement District No. 345 Bond (DNRC State Revolving Fund) Series 2014
NONE
10a Name and title of officer or other employee of the issuer whom the IRS may call for more information (see
10b Telephone number of officer or other
instructions)
employee shown on 10a
Rick Wills, City Finance Director
406-758-7701
Type of Issue (enter the issue price). See the instructions and attach schedule.
11 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 Health and hospital . . . . . . . . . . . . . . . . . . . . . . . . . .
13 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . .
14 Public safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
15 Environment (including sewage bonds) . . . ... . . . . . . . . . . . . . . .
16 Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
17 Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
18 Other. Describe ► improvements to the storm water detention facility of the district
11
12
13
14
15
16
17
18 242,000
00
19 If obligations are TANS or RANs, check only box 19a . . . . . . . . . . . . . 0.❑
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.
(a) Final maturity date
(b) Issue price
(c) Stated redemption
price at maturity
(d) Weighted
I average maturity
(e) Yield
21
07/01/2029
$ 242,000
$ 242,0001
8.493 years
1
3.0002925
Uses of Proceeds of Bond Issue (including underwriters' discount)
22
23
24
25
26
27
28
29
30
Proceeds used for accrued interest . . . . . . . . . . . . . . . . . . . .
Issue price of entire issue (enter amount from line 21, column (b)) . . . . .
Proceeds used for bond issuance costs (including underwriters' discount) . . 24 11,000
Proceeds used for credit enhancement . . . . . . 25 0
Proceeds allocated to reasonably required reserve or replacement fund 26 23,272
Proceeds used to currently refund prior issues . . . . . . . . . 27 0
Proceeds used to advance refund prior issues . . . . . . . . . 28 0
Total (add lines 24 through 28) . . . . . . . . . . . . . . . . . . . . . .
Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) . .
.
00
00
33
00,
00
.
.
22
0
00
23
242,000
00
34,272
33
29
30
207,727
67
I:FreDescription
of Refunded Bonds. Complete this part only for refunding bonds.
31
32
33
34
Enter the remaining weighted average maturity of the bonds to be currently refunded . . . .
Enter the remaining weighted average maturity of the bonds to be advance refunded . . . .
Enter the last date on which the refunded bonds will be called (MM/DD/YYYY) . . . . . .
Enter the dates) the refunded bonds were issued ► (MM/DD/YYYY)
►
►
►
years
years
For Paperwork Reduction Act Notice, see separate instructions. cat. No. 63773S Form
8038-G (Rev. 9-2011)
Form 8038-G (Rev.9-2011)
Page 2
Miscellaneous
35
Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . . . 35
0 00
36a
Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contractf.,'
(GIC) (see instructions) ... . . . . . • • . • • • • • • • • • • • • • • 36a
0 00
b
Enter the final maturity date of the GIC ►
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
01 00
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 obligation ► 10/17/2013
c
Enter the EIN of the issuer of the master pool obligation ► 81-0001067
d
Enter the name of the issuer of the master pool obligation ► State of Montana
39
If the issuer has designated the issue under section 265(b)(3)(B)(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 ►
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 . . . . . . . . . ► $242,000
b
Enter the date the official intent was adopted ► 06/18/2012
Under penalties of perjury, I declare that.] 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
and
process this return, to the person that I have authorized above.
Consent
�1...
' Mark Johnson, Mayor
'
Signature of issuer's horized representative Date
Type or print name and title
Paid
Print/Type preparer's name
Prepe�' signatur
�
Date
�'� �
Check ❑ if
PTIN
Dan Semmens
self-employed
P01069444
Preparer
41-0223337
Only
Firm's name ► Dorsey &Whitney LLP
Firm's EIN ►
Use
Firm's address ► 125 Bank Street, Suite 600, Missoula, T 59802
Phone no. 406-721-6025
Form 8038-G (Rev. 9-2011)
■ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Internal Revenue Service
Ogden, UT 84201
A. Signature
❑ Agent
X ❑ Addressee .
B. Received by (Printed Name) C. Date of Delivery/,
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: WNo
3. Service Type
Certified Mail Express Mail
Registered JM Return Receipt for Merchandise
❑ Insured Mail ❑ C.O.D.
4. Restricted Delivery? (Extra Fee) ❑ Yes
i
2. Article Number
I (transfer from service label) 7 010 0290 0001 1976 5859
PS Form 3811., February 2004 Domestic Return Receipt 10259e-02-M-1540
I
{
UNITED STATES POSTAL. SERVICE First -Class Mail
Postage & Fees Paid
USPS
Permit No. G16
I
I • Sender: Please print your name, address, and ZIP+4 in this box •
I
I
�I
I Q 2SE:y
000 & W iiti irY LLP
l 12Suite'600
I Missoula; Mt 5 ,$0.2-4407
;I
I
I
;4
I
I✓ !fir%�raye iJattr ✓_ P'r Pr*'r-"e w
O i PtsD 1tL6
'III.0 $G
F4ue,•
f -AiMiff
ltcV�+UDall . y'SD Z CF 360 'K44,Jp c'a- SID W 2KS ia"� wak, (gip
L2a,�. G%"�'f`' Pa�k;� Gt►� f3.•k,:,.y �j•
Err1
� •
°
� ' • e
Lnt
co
co
L'(1 .
to
0 F F
I C I A
L USE
$
b 3
Z
Er
Q'
Postage
.
Certified Fee
30
ra
a
Postmark
® 0
E:3
Return Receipt Fee
-4-0
Here
M
O
(Endorsement Required)
2.
C3
El
Restricted Delivery Fee
O'
E:3
(EndorsementRequired)
®
ru
Total Postage & Fees
U '
O
O
Z f
----- "— c3
�
Sent %
2
..�. rZIE3
O
CI
sf�eel, Apt No.:
------------------------
--------------
r"
or PO Box No.
City, State, ZIP+4
CC, P j