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.
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