Instructions For Form 8038-G - Information Return For Tax-Exempt Governmental Obligations - Internal Revenue Service - 2011 Page 2

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Issue. Generally, obligations are treated
return for the same date of issue. If you
exchanges the bonds that are part of the
as part of the same issue if they are
are filing to correct errors or change a
issue for the underwriter’s (or other
issued by the same issuer, on the same
previously filed return, check the
purchaser’s) funds. For a lease or
date, and in a single transaction, or a
Amended Return box in the heading of
installment sale, enter the date interest
series of related transactions. However,
the form.
starts to accrue in a MM/DD/YYYY
obligations issued during the same
format.
The amended return must provide all
calendar year (a) under a loan agreement
the information reported on the original
Line 8. If there is no name of the issue,
under which amounts are to be advanced
return, in addition to the new or corrected
please provide other identification of the
periodically (a “draw-down loan”) or (b)
information. Attach an explanation of the
issue.
with a term not exceeding 270 days, may
reason for the amended return and write
be treated as part of the same issue if the
Line 9. Enter the CUSIP (Committee on
across the top, “Amended Return
obligations are equally and ratably
Uniform Securities Identification
Explanation.” Failure to attach an
secured under a single indenture or loan
Procedures) number of the bond with the
explanation may result in a delay in
agreement and are issued under a
latest maturity. If the issue does not have
processing the form.
common financing arrangement (for
a CUSIP number, write “None.”
Line 1. The issuer’s name is the name of
example, under the same official
the entity issuing the obligations, not the
Line 10a. Enter the name and title of the
statement periodically updated to reflect
name of the entity receiving the benefit of
officer or other employee of the issuer
changing factual circumstances). Also, for
the financing. For a lease or installment
whom the IRS may call for more
obligations issued under a draw-down
sale, the issuer is the lessee or the
information. If the issuer wishes to
loan that meet the requirements of the
purchaser.
designate a person other than an officer
preceding sentence, obligations issued
or other employee of the issuer (including
during different calendar years may be
Line 2. An issuer that does not have an
a legal representative or paid preparer)
treated as part of the same issue if all of
employer identification number (EIN)
whom the IRS may call for more
the amounts to be advanced under the
should apply for one on Form SS-4,
information about the return, enter the
draw-down loan are reasonably expected
Application for Employer Identification
name, title, and telephone number of
to be advanced within 3 years of the date
Number. You can get this form on the IRS
such person on lines 3a and 3b.
of issue of the first obligation. Likewise,
website at IRS.gov or by calling
obligations (other than private activity
1-800-TAX-FORM (1-800-829-3676). You
Complete lines 10a and 10b even
bonds) issued under a single agreement
may receive an EIN by telephone by
!
if you complete lines 3a and 3b.
that is in the form of a lease or installment
following the instructions for Form SS-4.
CAUTION
sale may be treated as part of the same
Line 3a. If the issuer wishes to authorize
issue if all of the property covered by that
a person other than an officer or other
Part II—Type of Issue
agreement is reasonably expected to be
employee of the issuer (including a legal
delivered within 3 years of the date of
representative or paid preparer) to
Elections referred to in Part II are
issue of the first obligation.
communicate with the IRS and whom the
!
made on the original bond
Arbitrage rebate. Generally, interest on
IRS may contact about this return
documents, not on this form.
CAUTION
a state or local bond is not tax-exempt
(including in writing or by telephone),
unless the issuer of the bond rebates to
enter the name of such person here. The
Identify the type of obligations issued
the United States arbitrage profits earned
person listed in line 3a must be an
by entering the corresponding issue price
from investing proceeds of the bond in
individual. Do not enter the name and title
(see Issue price under Definitions earlier).
higher yielding nonpurpose investments.
of an officer or other employee of the
Attach a schedule listing names and EINs
See section 148(f).
issuer here (use line 10a for that
of organizations that are to use proceeds
purpose).
of these obligations, if different from those
Construction issue. This is an issue of
of the issuer, include a brief summary of
tax-exempt bonds that meets both of the
Note. By authorizing a person other than
the use and indicate whether or not such
following conditions:
an authorized officer or other employee of
user is a governmental or
the issuer to communicate with the IRS
1. At least 75% of the available
nongovernmental entity.
and whom the IRS may contact about this
construction proceeds are to be used for
return, the issuer authorizes the IRS to
construction expenditures with respect to
Line 18. Enter a description of the issue
communicate directly with the individual
property to be owned by a governmental
in the space provided.
entered on line 3a and consents to
unit or a section 501(c)(3) organization,
Line 19. If the obligations are short-term
disclose the issuer’s return information to
and
tax anticipation notes or warrants (TANs)
that individual, as necessary, to process
2. All the bonds that are part of the
or short-term revenue anticipation notes
this return.
issue are qualified 501(c)(3) bonds,
or warrants (RANs), check box 19a. If the
bonds that are not private activity bonds,
Lines 4 and 6. If you listed an individual
obligations are short-term bond
or private activity bonds issued to finance
on line 3a to communicate with the IRS
anticipation notes (BANs), issued with the
property to be owned by a governmental
and whom the IRS may contact about this
expectation that they will be refunded with
unit or a section 501(c)(3) organization.
return, enter the number and street (or
the proceeds of long-term bonds at some
P.O. box if mail is not delivered to street
In lieu of rebating any arbitrage that
future date, check box 19b. Do not check
address), city, town, or post office, state,
both boxes.
may be owed to the United States, the
and ZIP code of that person. Otherwise,
issuer of a construction issue may make
enter the issuer’s number and street (or
Line 20. Check this box if property other
an irrevocable election to pay a penalty.
P.O. box if mail is not delivered to street
than cash is exchanged for the obligation,
The penalty is equal to 1
/
% of the
1
2
address), city, town, or post office, state,
for example, acquiring a police car, a fire
amount of construction proceeds that do
and ZIP code.
truck, or telephone equipment through a
not meet certain spending requirements.
series of monthly payments. (This type of
Note. The address entered on lines 4
See section 148(f)(4)(C) and the
obligation is sometimes referred to as a
and 6 is the address the IRS will use for
Instructions for Form 8038-T.
“municipal lease.”) Also check this box if
all written communications regarding the
real property is directly acquired in
Specific Instructions
processing of this return, including any
exchange for an obligation to make
notices.
periodic payments of interest and
Part I—Reporting Authority
Line 5. This line is for IRS use only. Do
principal. Do not check this box if the
not make any entries in this box.
Amended return. An issuer may file an
proceeds of the obligation are received in
amended return to change or add to the
Line 7. The date of issue is generally the
the form of cash, even if the term “lease”
information reported on a previously filed
date on which the issuer physically
is used in the title of the issue.
-2-

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