Form 8038-T Arbitrage Rebate Yield Reduction And Penalty In Lieu Of Arbitrage Rebate {8038-T} | Pdf Fpdf Doc Docx | Official Federal Forms

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Form 8038-T Arbitrage Rebate Yield Reduction And Penalty In Lieu Of Arbitrage Rebate {8038-T} | Pdf Fpdf Doc Docx | Official Federal Forms

Form 8038-T Arbitrage Rebate Yield Reduction And Penalty In Lieu Of Arbitrage Rebate {8038-T}

This is a Official Federal Forms form that can be used for Department Of Treasury.

Alternate TextLast updated: 11/1/2011

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Form 8038-T Reporting Authority Issuer's name (Rev. April 2011) Department of the Treasury Internal Revenue Service Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate Under Sections 143(g)(3) and 148(f) and Section 103(c)(6)(D) of the Internal Revenue Code of 1954 OMB No. 1545-1219 Part I 1 3 5 7 9 Check box if Amended Return 2 Room/suite 4 6 8 10 Issuer's employer identification number (EIN) Report number (For IRS Use Only) Number and street (or P.O. box no. if mail is not delivered to street address) City, town, or post office, state, and ZIP code Name of issue 7 Date of issue CUSIP number Telephone number of officer or other person Name and title of officer of the issuer or other person whom the IRS may call for more information Part II 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 11 Type of issue Issue price Arbitrage Rebate and Yield Reduction Payments 11 Amount Computation date to which this payment relates (MM/DD/YYYY) . . . . . Arbitrage rebate payment (see instructions) check box if less than 100% of rebate amount . . . Yield reduction payment (see instructions) check box if less than 100% of yield reduction amount Rebate payment from Qualified Zone Academy Bond (QZAB) defeasance escrow (see instructions) . . 13 14 15 Part III Penalty in Lieu of Arbitrage Rebate 24 mos ... ... ... Other. No. of mos ....... .. ....... . . . . . . . . . . . . . Yes . . . . . . . . . . . . . . . . Number of months since date of issue: 6 mos 12 mos 18 mos Penalty in lieu of rebate . . . . . . . Date of termination election (MM/DD/YYYY) . Penalty upon termination ...... . . . . . . . . . . . . . . . . No . . . . . . . . 21 22 23 24 25 26 27 Yes Is the issue a variable rate issue? . Did the issuer enter into a hedge? . . ...... Name of provider Term of hedge Name of provider Term of GIC . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 29 30 31 No . . 17 19 Part IV Late Payments . . . . . . . . . . . . . . Does failure to pay timely qualify for waiver of penalty (see instructions) . Penalty for failure to pay on time (see instructions) Interest on underpayment (see instructions) . . Part V Part VI Total Payment Miscellaneous . . . . . . . . Total payment. Add lines 13, 14, 15, 17, 19, 21, and 22. Enter total here Unspent proceeds as of this computation date Proceeds used to redeem bonds . . . . . . . . . . . . . . . . . . . . . Gross proceeds used for qualified administrative costs for guaranteed investment contracts (GICs) and defeasance escrows . . . . . . . . . . . . . . . . . . . . . . . . . Fees paid for a qualified guarantee . . . . . . . . . . . . . . . . . . . . . Were gross proceeds invested in a GIC? Were any gross proceeds invested beyond an available temporary period? . . . . Calculations for filing of this form prepared by: Issuer Preparer: Signature and Consent Under penalties of perjury, I declare that I have examined this return, and accompanying schedules and statements, and to the best of my knowledge and belief, they are true, correct, and complete. I further declare that I consent to the IRS's disclosure of the issuer's return information, as necessary to process this return, to the person that I have authorized above. Signature of issuer's authorized representative Date Type or print name and title Date Check if self-employed Firm's EIN Phone no. Paid Preparer Use Only Print/Type preparer's name Preparer's signature PTIN Firm's name Firm's address For Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 11545Y Form 8038-T (Rev. 4-2011) American LegalNet, Inc. www.FormsWorkFlow.com

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