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Line 2—Issuer’s employer identification

dated to the date of issue (if payable at

fees for credit enhancement that are taken

number (EIN).—An issuer that does not have

regular intervals of one year or less). The

into account in determining the yield on the

an EIN should apply for one on Form SS-4,

stated redemption price at maturity is the

issue for purposes of section 148(h) (e.g.,

Application for Employer Identification

amount payable (without regard to optional

bond insurance premiums and certain fees for

Number. This form may be obtained from

redemptions) at maturity (excluding interest

letters of credit).

most IRS and Social Security Administration

payable at regular intervals of 1 year or less).

Line 25—Proceeds allocated to reasonably

offices. File Form SS-4 according to the

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

required reserve or replacement fund.—

instructions on that form. If the EIN has not

line 19, columns (a) through (d).

Enter the amount of the original proceeds

been received by the due date for Form

Line 20—Columns (c), (d), and (e).—Enter

that will be allocated to such a fund.

8038-G, write “Applied for” in the space for

the issue price, stated redemption price at

Line 26—Proceeds used to refund prior

the EIN.

maturity, and weighted average maturity in

issues.—Enter the amount of the original

Line 4—Report number.—Number reports

years (e.g., 8.7 years). The stated redemption

proceeds that will be used to pay principal,

consecutively based on the filing date (not

price at maturity of the entire issue is the sum

interest, or call premium on any other issue of

the date of issue). For example, if the issuer

of the stated redemption prices at maturity of

bonds.

filed two Forms 8038-G in the 1993 calendar

each bond issued as part of the issue. For a

Line 28—Nonrefunding proceeds of

year, the “report number” for the third Form

lease or installment sale, enter “N/A” on line

issue.—Enter the amount received by the

8038-G would be “G1993-3.” If an issuer

20, column (d).

issuer net of any issuance costs and credit

(e.g., a state) issues obligations through many

The weighted average maturity is the sum

enhancement fees, and net of proceeds

departments or agencies, the issuer may

of the products of the issue price of each

allocated to a reasonably required reserve or

assign a letter of the alphabet to each

maturity and the number of years to maturity

replacement fund and proceeds used for

department or agency and each may

(determined separately for each maturity and

refunding prior issues (including advance

separately number its reports by indicating

by taking into account mandatory

refunding). (Subtract line 27 from line 22 and

both the report number and letter (e.g.,

redemptions), divided by the issue price of

enter amount on line 28).

G1993-5-C, G1993-2-D).

the entire issue (from line 20, column (c)). For

Part V—Description of Refunded

Line 6—Date of issue.—Enter the date of

a lease or installment sale, enter the total

issue. This is generally the date on which the

number of years the lease or installment sale

Bonds

issuer physically exchanges the bonds that

will be outstanding.

Complete this part only if the bonds are to be

are part of the issue for the underwriter’s (or

Line 20—Columns (f) and (g).—Enter the

used to refund a prior issue of tax-exempt

other purchaser’s) funds. For a lease or

yield as defined in section 148(h), only if it

bonds. For a lease or installment sale, enter

installment sale, enter the date interest starts

has been computed. The yield is the discount

“N/A” on Part V.

to accrue.

rate that, when used to compute the present

Line 29.—Enter the remaining weighted

Line 7—Name of issue.—Enter the name of

value of all payments of principal and interest

average maturity of the bonds being

the issue, if one exists.

to be paid on the obligation, produces an

refunded. Determine the remaining weighted

amount equal to the purchase price, including

Line 8—CUSIP Number.—Enter the CUSIP

average maturity without regard to the

accrued interest. If the issue is a variable rate

(Committee of Uniform Securities

refunding. The weighted average maturity is

issue, enter “VR” as the yield of the issue. If

Identification Procedure) number of the bond

determined in the same manner as on line 20,

the issue is a lease or installment sale, enter

with the latest maturity. If the issue does not

column (e).

the effective rate of interest being paid.

have a CUSIP number, write “None.”

Line 30.—Enter the last date on which any of

Enter the net interest cost percentage (NIC)

the bonds being refunded will be called.

Part II—Type of Issue

in column (g). The NIC for an issue may be

Line 31.—Enter the date of issue of the

determined by dividing the total interest

Identify the type of obligations issued by

bonds being refunded. If more than a single

payments for the issue (reduced by any

checking the appropriate box(es) and entering

issue of bonds will be refunded, enter the

premium or accrued interest and increased by

the corresponding issue price. The issue price

date of issue of each issue.

any discount) by the product of the issue

does not include interest from the date the

price from line 20, column (c) and the

obligations are dated to the date of issue (if

Part VI—Miscellaneous

weighted average maturity from line 20,

payable at regular intervals of one year or

Line 32.—Enter the amount of the issuer’s

column (e). If it is a variable rate issue, enter

less).

state volume cap allocated to the issue under

“VR” as the NIC of the issue. For other than

Lines 9 and 10.—Attach a schedule listing

section 141(b)(5).

variable rate issues, carry the yield and the

names and employer identification numbers

NIC out to three decimal places (e.g.

Line 33.—If any portion of the issue will

(EINs) of organizations that are to use

5.125%).

qualify for the small issuer exception to

proceeds of these obligations.

section 265 contained in section

Part IV—Uses of Original Proceeds of

Line 16.—Check the box on this line only if

265(b)(3)(B)(i)(III), enter the amount of the

lines 9–15 do not apply. Enter a description

Bond Issues

obligations that will qualify for the exception.

of the issue in the space provided.

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

Line 34a.—Enter the amount of this issue

Part III—Description of Obligations

Part IV.

used to fund a loan to another governmental

unit, the interest of which is tax exempt.

Line 21—Proceeds used for accrued

Line 19.—Enter the maturity date, the interest

interest.—Enter the amount of original

Line 35.—Check this box if the issue is a

rate (or coupon rate), the issue price, and the

proceeds that will be used to pay interest

stated redemption price at maturity. If there is

construction issue and an irrevocable election

from the date the bonds are dated to the

to pay a penalty in lieu of arbitrage rebate

more than one maturity date for bonds that

date of issue.

has been made on or before the date the

are part of the issue, enter the information for

bonds were issued. The penalty is payable

the bonds with the latest maturity date.

Line 23—Proceeds used for bond issuance

with a Form 8038-T for each 6-month period

Interest rates should be carried out to three

costs.—Enter the amount of the original

after the date the bonds are issued. Do not

decimal places. If the interest rate is a

proceeds that will be used to pay bond

make any payment of penalty in lieu of rebate

variable rate, enter “VR.” If the bonds are

issuance costs, including fees for trustees

with this form. See Rev. Proc. 92-22, 1992-12

reoffered to the public, the issue price should

and bond counsel.

be based on the reasonably expected

I.R.B. 33 for rules regarding the “election

Line 24—Proceeds used for credit

document.”

reoffering price. The issue price does not

enhancement.—Enter the amount of the

include interest from the date the bonds are

original proceeds that will be used to pay

Signature

An authorized representative of the issuer

must sign Form 8038-G.

Page 2

Instructions For Form 8038-G - Information Return For Tax-Exempt Governmental Obligations - 1993 Page 2

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