Instructions For Form 8038-G (Rev. 2012) (Page 3 of 4) in pdf

of the issuer, include a brief summary of

than variable rate issues, carry the yield

more than the amount that would cause

the use and indicate whether or not such

out to four decimal places (for example,

the issue to be private activity bonds.

user is a governmental or

5.3125%). If the issue is a lease or

Line 36. If any portion of the gross

nongovernmental entity.

installment sale, enter the effective rate of

proceeds of the issue is or will be invested

interest being paid.

Line 18. Enter a description of the issue

in a guaranteed investment contract (GIC),

Part IV—Uses of Proceeds of

in the space provided.

as defined in Regulations section

1.148-1(b), enter the amount of the gross

Bond Issue

Line 19. If the obligations are short-term

proceeds so invested, as well as the final

tax anticipation notes or warrants (TANs)

For a lease or installment sale, write “N/A”

maturity date of the GIC and the name of

or short-term revenue anticipation notes or

in the space to the right of the title for Part

the provider of such contract.

warrants (RANs), check box 19a. If the

IV.

obligations are short-term bond

Line 37. If the issue is a pooled financing

Line 22. Enter the amount of proceeds

anticipation notes (BANs), issued with the

issue (as defined under Pooled financing

that will be used to pay interest from the

expectation that they will be refunded with

issue in Definitions), enter the amount of

date the bonds are dated to the date of

the proceeds of long-term bonds at some

the proceeds used to make loans to other

issue.

future date, check box 19b. Do not check

governmental units, the interest on which

both boxes.

is tax-exempt.

Line 24. Enter the amount of the

proceeds that will be used to pay bond

Line 20. Check this box if property other

Line 38. If the issue is a loan of proceeds

issuance costs, including fees for trustees

than cash is exchanged for the obligation,

from a pooled financing issue (as defined

and bond counsel. If no bond proceeds

for example, acquiring a police car, a fire

under Pooled financing issue in

will be used to pay bond issuance costs,

truck, or telephone equipment through a

Definitions), check the box and where

enter zero. Do not leave this line blank.

series of monthly payments. (This type of

asked for the date of issue, EIN, and name

obligation is sometimes referred to as a

of the issuer of the master pool obligation,

Line 25. Enter the amount of the

“municipal lease.”) Also check this box if

enter the date of issue, EIN, and name of

proceeds that will be used to pay fees for

real property is directly acquired in

the issuer of the pooled financing issue.

credit enhancement that are taken into

exchange for an obligation to make

account in determining the yield on the

Line 40. Check this box if the issue is a

periodic payments of interest and

issue for purposes of section 148(h) (for

construction issue and an irrevocable

principal. Do not check this box if the

example, bond insurance premiums and

election to pay a penalty in lieu of

proceeds of the obligation are received in

certain fees for letters of credit).

arbitrage rebate has been made on or

the form of cash, even if the term “lease” is

before the date the bonds were issued.

Line 26. Enter the amount of proceeds

used in the title of the issue.

The penalty is payable with a Form 8038-T

that will be allocated to such a fund.

Part III—Description of

for each 6-month period after the date the

Line 27. Enter the amount of the

bonds are issued. Do not make any

Obligations

proceeds that will be used to pay principal,

payment of penalty in lieu of arbitrage

interest, or call premium on any other

Line 21. For column (a), the final maturity

rebate with this form. See Rev. Proc.

issue of bonds within 90 days of the date

date is the last date the issuer must

92-22, 1992-1 C.B. 736 for rules regarding

of issue.

redeem the entire issue.

the “election document.”

Line 28. Enter the amount of the

For column (b), see Issue price under

Line 41a. Check this box if the issuer

proceeds that will be used to pay principal,

Definitions earlier.

has identified a hedge on its books and

interest, or call premium on any other

records according to Regulations sections

For column (c), the stated redemption

issue of bonds after 90 days of the date of

1.148-4(h)(2)(viii) and 1.148-4(h)(5) that

price at maturity of the entire issue is the

issue, including proceeds that will be used

permit an issuer of tax-exempt bonds to

sum of the stated redemption prices at

to fund an escrow account for this

identify a hedge for it to be included in

maturity of each bond issued as part of the

purpose.

yield calculations for computing arbitrage.

issue. For a lease or installment sale, write

Part V—Description of

“N/A” in column (c).

Line 42. In determining if the issuer has

Refunded Bonds

For column (d), the weighted average

super-integrated a hedge, apply the rules

maturity is the sum of the products of the

of Regulations section 1.148-4(h)(4). If the

Complete this part only if the bonds are to

issue price of each maturity and the

hedge is super-integrated, check the box.

be used to refund a prior issue of

number of years to maturity (determined

tax-exempt bonds. For a lease or

Line 43. If the issuer takes a “deliberate

separately for each maturity and by taking

installment sale, write “N/A” in the space

action” after the issue date that causes the

into account mandatory redemptions),

to the right of the title for Part V.

conditions of the private business tests or

divided by the issue price of the entire

the private loan financing test to be met,

issue (from line 21, column (b)). For a

Lines 31 and 32. The remaining

then such issue is also an issue of private

weighted average maturity is determined

lease or installment sale, enter instead the

activity bonds. Regulations section

without regard to the refunding. The

total number of years the lease or

1.141-2(d)(3) defines a deliberate action

installment sale will be outstanding.

weighted average maturity is determined

as any action taken by the issuer that is

in the same manner as on line 21, column

For column (e), the yield, as defined in

within its control regardless of whether

(d).

section 148(h), is the discount rate that,

there is intent to violate such tests.

when used to compute the present value

Line 34. If more than a single issue of

Regulations section 1.141-12 explains the

of all payments of principal and interest to

bonds will be refunded, enter the date of

conditions to taking remedial action that

be paid on the obligation, produces an

issue of each issue. Enter the date in an

prevent an action that causes an issue to

amount equal to the purchase price,

MM/DD/YYYY format.

meet the private business tests or private

including accrued interest. See

loan financing test from being treated as a

Part VI—Miscellaneous

Regulations section 1.148-4 for specific

deliberate action. Check the box if the

rules to compute the yield on an issue. If

issuer has established written procedures

Line 35. An allocation of volume cap is

the issue is a variable rate issue, write

to ensure timely remedial action for all

required if the nonqualified amount for the

“VR” as the yield of the issue. For other

nonqualified bonds according to

issue is more than $15 million but is not

-3-

Instructions For Form 8038-G (Rev. 2012) Page 3

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