Form 8038-G/Information Return for Tax-Exempt Governmental ObligationsTAXPAYERS
Form 8038-G Information Return for Tax -Exempt Governmental Obligations
(Rev. September 2011) ► Under Internal Revenue Code section 149(e) OMB No. 1545-0720
0-See separate instructions.
Department of the Treasury Internal Revenue Service Caution: ff the issue price is under $100,000, use Form 8038-GC.
Reporting Authority If Amended Return, check here ► [
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
13
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
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 . . . . . . . . ► ❑
11
12
13
14
15
16
17
18
1 242,0001
00
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
07/01/2029
$ 242,000
242,000
8.493 years
3.0002925 %
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 11,000 00
25 Proceeds used for credit enhancement . . . . . . . . . . . . 25 0 00
26 Proceeds allocated to reasonably required reserve or replacement fund 26 23,272 33
27 Proceeds used to currently refund prior issues . . . . . . . . . 27 0 00
28 Proceeds used to advance refund prior issues . . . . . . . . . 28 0 00
29 Total (add lines 24 through 28) . . . . . . . . . . . . . . . . . . . . . . .
30 Nonrefunding proceeds of the issue (subtract line 29 from line 23 and enter amount here) . .
22
0
00
23
242,000
00
.
34,272
33
-
i
t
29
30
1 207,727
67
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 . . . . ► 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/YYYI) . . . . . . ►
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. 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 contract
(GIC) (see instructions) . . . . . . . . . . . . . . . . . . . . . . . . 36a
0 00
b
Enter the final maturity date of the GIC ► IWA
E
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 t%zz
to other governmental units . . . . . . . . . . . . . . . . . . . . . . . . 37
0 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 ► 10117/2013
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)(13)(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 adapted ► 06/18/2012
Under penalties of perjury, I declare that I have examined this return and a 'r`�panying schedules and statements, and to the best of my knowledge
Signature and belief, they are true, correct, and complete. I further declare that n t to the IRS's disclosure of the issuer's return information, as necessary to
and process this return, to the erson that I have authorized above.
Consent ' ' Mark Johnson, Mayor
Signature of issuer' a thorized representative Date Type or print name and title
Paid Print/Type preparer's name#raer's signature Date Check ❑ if PTIN
Preparer Dan Semmens self-employed P01069444
Use Only Firm's name ► Dorsey & Whitney LLP Firm's EIN ► 41-0223337
Firm's address ► 125 Bank Street, Suite 600, Missoula, MT 59802 Phone no. 406.721-6025
Form 8038-G (Rev. 9-2011)