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Tab 27 IRS Form 8038-GD o PSEY & WHITNEY PIROFESSIONA.L DMITED LiA-BILITY PARTNERSHIP MINNEAPOI,IS NEW YORH 127 EAST FRONT STIE?EET ROCHESTER, MN SUITE 310 WASHINGTON, D. C. MISSOULA2 MONTANA 59802 BILEINGS (406)721-6025 OIRA-WGE COUNT-f-7 CA FAX (406) 543-0863 GREAT FAEES F-&IRGO DES MOINES LONI)ON AME NAN ELLINGSON DEN-VER BRUSSEES September 29, 1995 CERTIFIED MAIL RETURN RECEIPT REQUESTED Internal Revenue Service Philadelphia, PA 19255 Re: $100,000 Special Improvement District No. 341 Bonds City of Kalispell, Montana Dear Sir/Madam: Enclosed are two 8038-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 MNE-.1mc Enclosures Form 8038-G I information Return for Tax -Exempt Governmental Obligations (Rev. May 1995) Department of the Treasury Internal Revenue SeMce 10- Under Internal Revenue Code section 149(e) 0- See separate Instructions. (Note: Use Form 8038-GC if the issue price is under $100,000.) I I OMB No. 1545-0720 [M R2porti-nq Auth�� �i If Amended Return, check here l0o- D 1 Issuer's name City of Kalispell, Montana 2 issuees employer identffication number 81:6001281 3 Number and street (or P.O. box If mail is not delivered to street address) 312 1st Avenue East Roorn/suite 4 Report number G19 95-1 5 City, town, or post office, state, and ZIP code Kalispell, Montana 59901 6 Date of issue 09/26/95 7 Name of issue Special Improvement District No. 341 Bonds 8 CUSIP number 483408 9Q5 Type of Issue (check applicable box(es) and enter the issue priSe 9 10 11 1.2 13 14 15 16 17 18 EJ Education (attach schedule -see instructions) . . . . . . . . . . . . . . . . . 0 Health and hospital (attach schedule -see instructions) . . . . . . . . . . . . . . El Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . . El Public safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Environment (including sewage bonds) . . . . . . . . . . . . . . . . . . . El Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . El Utilities . . . . a . . . . . . - ' * ' El Other. Describe (see instructions) 10- instaliation 'of'a*sanj:tar'y*s.e*w�r inain If obligations are tax or other revenue anticipation bonds, check box 1110. F-1 If ob 2ations are in the form of a lease or installment sale, check box 10- El 9 $ 10 11 12 13. 14 15 16 100,000 N.. Description of Obligations (a) Maturity date (b) Interest rate M Issue price (d) Stated redemption price at maturity (e) Weighted average maturity M Yield (9) Net interest cost 07/01/11 6.200/0 10 000 10 r 0 0 19 Final maturity. 100 000f_ 100,00 10. 013__E F VearS, 5 .698070 A % 20 Entire issue Uses of Proceeds of Bond Issue (including underwriters' discoun�) 21 Proceeds used for accrued interest . . . . . . . . . . . . . . . . . . . . . 21 383 22. 100,000 22 Issue price of entire issue (enter amount from line 20, column (c)) . . . . 0 . 0 & . - 23 Proceeds used for bond issuance costs (including underwriters' discount) 23 6..250 24 Proceeds used for credit enhancement . . . . . . . . . . . 0 24 0 25 26 27 Proceeds allocated to reasonably required reserve or replacement fund . 25 Proceeds used to currently refund prior issues . . . . . . . . 26 Proceeds used to advance refund prior issues . . . . . . . . t 0 10"no 0 0 28 Total (add lines 23 through 27) . . . . . . . . . . . . . . . . . . . . . . 28 16, 250 29 83,750 29 Nonrefundin2 proceeds of the issue Lsubtract line 28 from line 22 and enter amount here). I= Description of Refunded Bonds (Complete this part only jor_ refunding bonds.) 30 Enter the remaining weighted average maturity of the bonds to be currently refunded . . . 110- ars 31 Enter the remaining weighted average maturity of the bonds to be advance refunded . . . 0- ars 32- Enter the last date on which the refunded bonds will be called . . . . . . . . . . . 1110- 33 Enter the dateCsLthe refunded bonds were issued Pop- . ...... Miscellaneous 34 Enter the amount of the state volume cap allocated to the issue under section 141 (b)(5) U4 35 Enter the amount of the bonds designated by the issuer under section 265(b)(3)(B)(i)(111) (small issuer exception) 35 100,000 36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract (see 'Instructions) 36a 0 b Enter the final maturity date of the guaranteed investrnent contract . No- 0 37 Pooled financings: a Proceeds of this issue that are to be used to make loans to other govemmental units 37a b If this issue is a loan made from the proceeds of another tax-exempt issue,, check box Ilo- El and enter the name of the issuer OPP. and the date of the issue 00- 38 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box 0- El 39 If the issuer has identified a hedge, check box . . . . . . . . 00- El Under penalties of pedury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. Please Sign Douglas D. Rauthe, Mayor Here Signature of."Puer s authorii&d 'representative Date Type or print name and title For Paperwork Reduction Act Notice, see page I of the Instructions. G) Prkftd on recycW paper Cat. No. 63773S Form8M-G (Rev. 5-95) *U,s. Cwwrowat Prtntlng Offkxr. 19W — 397-096/20109