Form 8038-B - Information Return For Build America Bonds And Recovery Zone Economic Development Bonds

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8038-B
Information Return for Build America Bonds and Recovery Zone
Form
Economic Development Bonds
OMB No. 1545-2161
(January 2010)
Under Internal Revenue Code section 149(e)
Department of the Treasury
See separate instructions.
Internal Revenue Service
Part I
Reporting Authority
Check if Amended Return
1 Issuer’s name
2 Issuer’s employer identification number (EIN)
4 Report number (For IRS Use Only)
3 Name of person (other than issuer) with whom the IRS may communicate about this return (see instructions)
1
5 Number and street (or P.O. Box if mail is not delivered to street address)
6 City, town, or post office, state, and ZIP code
7 Date of issue (MM/DD/YYYY)
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8 Name of issue
9 CUSIP number
10 Name and title of officer of issuer whom the IRS may call for more information (see instructions)
11 Telephone number of officer or other person (see instructions)
Part II
Type of Bonds (see instructions, if the box on line 1b or 1c is checked, complete lines 2 and 3)
1 a Build America bonds (Tax Credit) (section 54AA(a)) .
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b Build America bonds (Direct Payment) (sections 54AA(g) and 6431) .
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c Recovery zone economic development bonds (Direct Payment) (sections 1400U-2 and 6431) .
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2
Enter the first interest payment date (MM/DD/YYYY)
3
Interest payment date frequency: (Check box) (see instructions and attach debt service schedule)
a
annual,
b
semi-annual,
c
quarterly,
d
monthly, or
e
other
f If line 3e above is checked, please describe the payment frequency:
Part III
Purpose of Issue
For a build America bond, identify the purpose of issue and enter the issue price. (see instructions
1
Amount
(Whole Dollars)
and attach schedule)
a Education .
1a
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b Health and hospital
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1b
c Transportation .
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1c
d Public safety .
1d
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e Environment (including sewage bonds) .
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1e
f Housing
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1f
1g
g Utilities .
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h Other description
1h
For a recovery zone economic development bond, identify the purpose of issue and enter the issue
2
price. (see instructions and attach schedule)
a Capital expenditures relating to property located in the zone .
2a
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b Public infrastructure and construction of public facilities
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2b
c Job training and educational programs .
2c
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d Other description .
2d
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3
Total issue price (Part III, lines 1a through 1h or lines 2a through 2d)
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3
4
If obligations are TANs or RANs, check only box 4a
If obligations are BANs, check only box 4b
5
If obligations are in the form of a lease or installment sale, check box
Part IV
Description of Obligations (Complete for the entire issue for which this form is being filed.)
1
Stated redemption price at maturity .
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1
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Final maturity date (MM/DD/YYYY)
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3
Weighted average maturity .
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years
4
Yield
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%
5
If the issue is a variable rate issue, check box 5a
Please indicate the frequency rates are reset 5b
8038-B
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Form
(1-2010)
Cat. No. 53393K

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