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Farm 6MR-GO (Rev. 1-2012) <br />street address. If a change in address occurs <br />after the return is filed, use Form 8822. <br />Change of Address, to notify the IRS of the <br />new address. <br />Note. The address entered on lines 3 and 4 is <br />the address the iRS will use for all written <br />communications regarding the processing of <br />this return, Including any notices. By <br />authorizing a person other than an authorized <br />officer or other employee of the Issuer to <br />communicate with the IRS and whom the iRS <br />may contact about this return, the issuer <br />authorizes the IRS to communicate directly <br />with the individual listed on fsne 6, whose <br />address is entered on lines 3 and 4 and <br />consents to disclose the issuer's return <br />information to that Individual, as necessary, to <br />process this return. <br />Line 5. This line is for IRS use only. Do not <br />make any entries In this box. <br />Part ii—Description of Obligations <br />Check the appropriate box designating this as <br />a return on a single issue basis or a <br />consolidated return basis. <br />Line Sa. The issue price of obligations is <br />generally determined under Regulations <br />section 1.148-1(b). Thus, when Issued for <br />cash, the Issue price is the price at which a <br />substantial amount of the obligations are sold <br />to the public. To determine the issue price of <br />an obligation issued for property, see sections <br />1273 and 1274 and the related regulations. <br />Line 9b. For a single Issue, enter the date of <br />issue (far example, 0311 5/2010 for a single <br />issue issued on March 16, 2010), generally <br />the date on which the issuer physically <br />exchanges the bonds that are part of the <br />Issue for the underwriter's (or other <br />purchaser's) funds; for a lease or installment <br />sale, enter the date Interest starts to accrue. <br />For issues reported on a consolidated basis, <br />enter the first day of the calendar year during <br />which the obligations were Issued (for <br />example, for calendar year 2010, enter <br />01/01/2010). <br />Lines 8a through 8h. Complete this section if <br />property other than cash is exchanged for the <br />obligation, for example, acquiring a police car, <br />afire truck, or telephone equipment through a <br />series of monthly payments. (Phis type of <br />obligation is sometimes referred to as a <br />"municipal lease.") Also complete this section <br />if real property is directly acquired In <br />exchange for an obligation to make periodic <br />payments of interest and principal. <br />Do not complete lines 9a through 9d H the <br />proceeds of an obligation are received in the <br />farm of cash even if the term "lease" is used <br />in the title of the issue. For lines ga through <br />9d, enter the amount on the appropriate line <br />that represents a lease or installment <br />purchase. For line 9d, enter the type of item <br />that Is leased_ For lines go through 9h, enter <br />the amount on the appropriate fine that <br />represents a bank loan. For line gh, enter the <br />type of bank loan. <br />Lines 91 and 9i. For line 91, enter the amount <br />of the proceeds that will be used to pay <br />principal, Interest, or call premium on any <br />other issue of bondsr including proceeds that <br />will be used to fund an escrow account for <br />We purpose. Several lines may apply to a <br />particular obligation. For example, report on <br />lines 9i and 9j obligations used to refund prior <br />issues which represent loans from the <br />proceeds of another tax-exempt obligation. <br />Line 9k. Enter on line 9k the amount on line <br />Ba that does not represent an obligation <br />described on lines gathrough 9J. <br />Line 10. Check this box if the Issuer has <br />designated any issue as a "small Issuer <br />exception" under section 265(b)(3)(B)(i)GII). <br />Line 11. Check this box If the issue Is a <br />construction issue and an irrevocable election <br />to pay a penalty in lieu of arbitrage rebate has <br />Wen made on or before the date the bonds <br />were issued. The penalty is payable with a <br />Form 8038-T for each 6-mont h period after <br />the date the bonds are issued. Do not make <br />any payment of penalty in lieu of rebate with <br />Form 8038-GC. See Rev. Proc. 92-22, <br />1992-1 G.B. 736, for rules regarding the <br />"election document." <br />Line f 2 Enter the name of the vendor or bank <br />who is a party to the installment purchase <br />agreement, loan, or financial lease. If there <br />are multiple vendors or banks, the Issuer <br />should attach a schedule. <br />Line 13. Enter the employer identification <br />number of the vendor or bank who is a party <br />to the installment purchase agreement, loan, <br />or financial Tease. If there are multiple vendors <br />or banks, the issuer should attach a schedule <br />Signature and Consent <br />An authorized representative of the issuer <br />must sign Form 8038-GC and any applicable <br />certiftoatlon. Also print the name and title of <br />the person signing Form 5038-CC. The <br />authorized representative of the Issuer slgning <br />this form must have the authority to consent <br />to the disclosure of the issuer's return <br />information, as neoessary to process this <br />return, to the person(s) that has been <br />designated in this form. <br />Note. tf the issuer authorizes In line 6 the IRS <br />to communicate with a person other than an <br />officer or other employee of the issuer, (such <br />authorization shall include contact both in <br />writing regardless of the address entered in <br />lines 3 and 4, and by telephone) by signing <br />this fort, the Issuer's authorized <br />representative consents to the disclosure of <br />the Issuer's return information, as necessary <br />to process this return, to such person. <br />Page S <br />Paid Preparer <br />it an authorized representative of the issuer <br />filled in its return, the paid preparer's space <br />should remain blank, Anyone who prepares <br />the return but does not charge the <br />organization should not sign the return. <br />Cedaln others who prepare the return should <br />not sign. For example, a regular, full-time <br />employee of the Issuer, such as a clerk, <br />secretary, etc., should not sign. <br />Generally, anyone who is paid to prepare a <br />return must sign it and fill In the other blanks <br />in the Paid Preparer Use Only area of the <br />return. A paid preparer cannot use a social <br />security number In the Paid Pmparer Use Onfy <br />box. The paid preparer must use a preparer <br />tax identification number (PTIN). If the paid <br />preparer Is self-employed, the preparer <br />should enter his or her address in the box. <br />The paid preparer must: <br />• Sign the return in the space provided for the <br />preparer's slg nature, and <br />• Give a Copy of the return to the issuer. <br />Paperwork Reduction Act Notice <br />We ask for the information on this form to <br />carry out the Internal Revenue laws of the <br />United States, You are required to give us the <br />information. We need it to ensure that you are <br />complying with these laws, <br />You are not required to provide the <br />information requested on a form that is <br />subject to the Paperwork Reduction Act <br />unless the fora displays a valid OMB control <br />number. Books or records relating to a form <br />or its instructions must be retained as long as <br />their contents may become material in the <br />administration of any Internal Revenue law. <br />Generally, tax returns and return information <br />are confidential, as required by section 6103. <br />The time needed to complete and file this <br />form will vary depending on individual <br />circumstances. The estimated average time is: <br />Leamfng about the <br />law or the form . . . . 4 hr., 46 min. <br />Preparing the form . . , 2 hr., 22 min. <br />Copying, assembling, and <br />sending the form to the IRS 2 hr., 34 min. <br />If you have comments concerning the <br />accuracy of these time estimates or <br />suggestions for making this form simpler, we <br />would be happy to hear from you. You can <br />write to the Internal Revenue Service, Tax <br />products Coordinating Committee, <br />SE:W:CAR:MP:T:M:S,1111 Constitution Ave. <br />NW, IR-6526, Washington, QC 20224. Do not <br />send the form to this address, instead, see <br />Where 7b file. <br />