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Form 8038-GC (Rev. 1-2012) Page 3
street address. If a change in address occurs Lines 9i and 9j. For line 9i, enter the amount Paid Preparer
after the return is filed, use Form 8822, of the proceeds that will be used to pay
Change of Address, to notify the IRS of the principal, interest, or call premium on any If an authorized representative of the issuer
new address. other issue of bonds, including proceeds that filled in its return, the paid preparer’s space
will be used to fund an escrow account for should remain blank. Anyone who prepares
Note. The address entered on lines 3 and 4 is this purpose. Several lines may apply to a the return but does not charge the
the address the IRS will use for all written particular obligation. For example, report on organization should not sign the return.
communications regarding the processing of lines 9i and 9j obligations used to refund prior Certain others who prepare the return should
this return, including any notices. By issues which represent loans from the not sign. For example, a regular, full-time
authorizing a person other than an authorized proceeds of another tax-exempt obligation. employee of the issuer, such as a clerk,
secretary, etc., should not sign.
officer or other employee of the issuer to Line 9k. Enter on line 9k the amount on line
communicate with the IRS and whom the IRS 8a that does not represent an obligation Generally, anyone who is paid to prepare a
may contact about this return, the issuer described on lines 9a through 9j. return must sign it and fill in the other blanks
authorizes the IRS to communicate directly in the Paid Preparer Use Only area of the
with the individual listed on line 6, whose Line 10. Check this box if the issuer has return. A paid preparer cannot use a social
address is entered on lines 3 and 4 and designated any issue as a “small issuer security number in the Paid Preparer Use Only
consents to disclose the issuer's return exception” under section 265(b)(3)(B)(i)(III). box. The paid preparer must use a preparer
information to that individual, as necessary, to Line 11. Check this box if the issue is a tax identification number (PTIN). If the paid
process this return. construction issue and an irrevocable election preparer is self-employed, the preparer
Line 5. This line is for IRS use only. Do not to pay a penalty in lieu of arbitrage rebate has should enter his or her address in the box.
make any entries in this box. been made on or before the date the bonds The paid preparer must:
were issued. The penalty is payable with a • Sign the return in the space provided for the
Part II—Description of Obligations Form 8038-T for each 6-month period after preparer’s signature, and
the date the bonds are issued. Do not make
Check the appropriate box designating this as any payment of penalty in lieu of rebate with • Give a copy of the return to the issuer.
a return on a single issue basis or a Form 8038-GC. See Rev. Proc. 92-22,
consolidated return basis. 1992-1 C.B. 736, for rules regarding the Paperwork Reduction Act Notice
Line 8a. The issue price of obligations is “election document.”
We ask for the information on this form to
generally determined under Regulations Line 12. Enter the name of the vendor or bank carry out the Internal Revenue laws of the
section 1.148-1(b). Thus, when issued for who is a party to the installment purchase United States. You are required to give us the
cash, the issue price is the price at which a agreement, loan, or financial lease. If there information. We need it to ensure that you are
substantial amount of the obligations are sold are multiple vendors or banks, the issuer complying with these laws.
to the public. To determine the issue price of should attach a schedule.
an obligation issued for property, see sections You are not required to provide the
1273 and 1274 and the related regulations. Line 13. Enter the employer identification information requested on a form that is
number of the vendor or bank who is a party subject to the Paperwork Reduction Act
Line 8b. For a single issue, enter the date of to the installment purchase agreement, loan, unless the form displays a valid OMB control
issue (for example, 03/15/2010 for a single or financial lease. If there are multiple vendors number. Books or records relating to a form
issue issued on March 15, 2010), generally or banks, the issuer should attach a schedule. or its instructions must be retained as long as
the date on which the issuer physically their contents may become material in the
exchanges the bonds that are part of the Signature and Consent administration of any Internal Revenue law.
issue for the underwriter’s (or other
purchaser’s) funds; for a lease or installment An authorized representative of the issuer Generally, tax returns and return information
sale, enter the date interest starts to accrue. must sign Form 8038-GC and any applicable are confidential, as required by section 6103.
For issues reported on a consolidated basis, certification. Also print the name and title of The time needed to complete and file this
enter the first day of the calendar year during the person signing Form 8038-GC. The form will vary depending on individual
which the obligations were issued (for authorized representative of the issuer signing circumstances. The estimated average time is:
example, for calendar year 2010, enter this form must have the authority to consent
01/01/2010). to the disclosure of the issuer's return Learning about the
information, as necessary to process this law or the form . . . . 4 hr., 46 min.
Lines 9a through 9h. Complete this section if return, to the person(s) that has been Preparing the form . . . . 2 hr., 22 min.
property other than cash is exchanged for the designated in this form.
obligation, for example, acquiring a police car, Copying, assembling, and
a fire truck, or telephone equipment through a Note. If the issuer authorizes in line 6 the IRS sending the form to the IRS . 2 hr., 34 min.
series of monthly payments. (This type of to communicate with a person other than an
obligation is sometimes referred to as a officer or other employee of the issuer, (such If you have comments concerning the
“municipal lease.”) Also complete this section authorization shall include contact both in accuracy of these time estimates or
if real property is directly acquired in writing regardless of the address entered in suggestions for making this form simpler, we
exchange for an obligation to make periodic lines 3 and 4, and by telephone) by signing would be happy to hear from you. You can
payments of interest and principal. this form, the issuer's authorized write to the Internal Revenue Service, Tax
representative consents to the disclosure of Products Coordinating Committee,
Do not complete lines 9a through 9d if the the issuer's return information, as necessary SE:W:CAR:MP:T:M:S, 1111 Constitution Ave.
proceeds of an obligation are received in the to process this return, to such person. NW, IR-6526, Washington, DC 20224. Do not
form of cash even if the term “lease” is used send the form to this address. Instead, see
in the title of the issue. For lines 9a through Where To File.
9d, enter the amount on the appropriate line
that represents a lease or installment
purchase. For line 9d, enter the type of item
that is leased. For lines 9e through 9h, enter
the amount on the appropriate line that
represents a bank loan. For line 9h, enter the
type of bank loan.
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