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Form 803E-GC (Rev.1-2at2) Page 3 street address. If a change in address occurs after the return Is filed, use Form 8622, Change of Address, to notify the IRS of the new address. Note. The address entered on lines 3 and 4 is the address the IRS will use for all written communications regarding the processing of this retum, Including any notices, By authorizing a person other than an authorized officer or other employee of the Issuer to communicate with the IRS and whom the IRS may contact about this return, the issuer authorizes the IRS to communicate directly with the individual listed on line 6, whose address is entered on lines 3 and 4 and consents to disclose the issuer's return information to that Individual, as necessary, to process this return. Line 5. This line is for IRS use only. Do not matte any entries in this box. Part II —Description of Obligations Check the appropriate box designating this as a return an a single issue basis or a consolidated return basis. Line Sae The issue price of obligations is generally determined under Regulations section 1.148-1(b). Thus, when issued for cash, the issue price is the price at which a substantial amount of the obligations are sold to the public. To determine the issue price of an obligation Issued for property, see sections 1273 and 1274 and the related regulations. Line Ob. For a single issue, enter the date of issue (for example, 03/15/2010 for a single issue issued on March 15, 2010), generally the data on which the issuer physically exchanges the bonds that are part of the issue for the underwriter's (or other purchaser's) funds; for a lease or installment sale, enter the date interest starts to accrue. For issues reported an a consolidated basis, enter the first day of the calendar year during which the obligations were issued (for example, for calendar year 2010, enter 01/w/2010). Lines 9a through 911. Complete this section if property other than cash Is exchanged for the obligation, for example, acquiring a police car, afire truck, or telephone equipment through a series of monthly payments. (This type of obligation is sometimes referred to as a "municipal lease.") Also complete This section If real property Is directly acquired in exchange for an obligation to make periodic payments of interest and p6noipal. Do not complete lines 9a through 9d if the proceeds of an obligation are received In the form of cash even If the term 'lease" is used in the titre of the issue. For lines 9a through 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 ge through gh, enter the amount on the appropriate line that represents a bank loan, For line 9h, enter the type of bank loan. Lines 9i and 9j. For line 91, enter the amount of the proceeds that will be used to pay principal, interest, or call premium on any other Issue of bonds, including Proceeds that will be used to fund an escrow account for this purpose. Several lines may apply to a particular obligation. For example, report on Ines 9i and 9j obligations used to refund prior issues which represent loans from the proceeds of another tax-exempt obligation. Line 9k. Enter on line 9k the amount on line 80 that does not represent an obligation described on lines 8a through 91. Lure 10, Check this box if the issuer has designated any issue as a "small issuer exception" under section Line 11. Check this box if the issue is a construction issue and an irrevocable election to pay a penalty in lieu of arbitrage rebate has been made on or before the data the bonds were issued. The penalty is Payable with a Form 8038-T for each 6-month period after the date the bonds are issued. Do not make any payment of penalty in lieu of rebate with Form 8038-GC, See Rev. Proc. 92-22, 1992-1 C.B. 736, for rules regarding the "election document." Line 12. Enter the name of the vendor or bank who is a party to the installment purchase agreement, loan, or financial lease. If there are multiple vendors or banks, the issuer should attach a schedule. tine 13. Enter the employer identification number of the vendor or bank who Is a party to the installment purchase agreement, loan, or financial lease. If there are multiple vendors or banks, the Issuer should attach a schedule. Signature and Consent An authorized representative of the Issuer must sign Form 8038-GC and any applicable certification. Also print the name and title of the person signing Form 8038-GC. The authorized representative of the Issuer signing this form must have the authority to consent to the disclosure of the issuer's return information, as necessary to process this return, to the person(s) that has been designated in this form. Note. If the issuer authorizes in line 6 the IRS to communicate with a person other than an officer or other employee of the Issuer, (such authorization shall include contact both in writing regardless of the address entered In lines 3 and 4, and by telephone) by signing this form, the issuer's authorized representative consents to the disclosure of the issuer's return information, as necessary to process this return, to such person. Paid Preparer If an authorized representative of the issuer filled in its retum, the paid preparer's space should remain blank. Anyone who prepares the return but does not charge the organization should not sign the return. Certain others who prepare the return should not sign. For example, a regular, full-time employee of the issuer, such as a clerk, secretary, etc., should not sign. Generally, anyone who Is paid to prepare a ratum must sign It and fill in the other blanks In the Paid Preparer Use Only area of the return. Apaid preparer cannot use a social security number in the Paid Preparar Use Only box, The paid preparer must use a preparer tax Identif€cation number (PTIN), If the paid Preparer is self-employed, the preparer should enter his or her address In the box_ The paid preparer must: • Sign the return In the space provided for the preparer's signature, and • Give a copy of the return to the issuer. Paperwork Reduction Act Notice We ask for the information on this form to carry out the internal Revenue laws of the United States. You are required to give us the information. We need it to ensure that you are complying with these laws. You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or Its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return Information are confidential, as required by section 6103. The time needed to complete and file this form will vary depending on individual circumstonoes. The estimated average time is: Learning sbord the law or the form . . . . 4 hr„ 46 min. Preparing the form _ _ . . 2 hr., 22 min. Copying, assembling, and sending the farm to the IRS . 2 hr., 34 min. If you have comments concerning the accuracy of these time estimates or suggestions for making this fort simpler, we would be happy to hear from you. You can write to the Internal Revenue Service, Tax Products Coordlnating Committee, SE:W:CAR:Mi :T:M:S,1111 Constitution Ave. NW, IR-0526, Washington, DC 20224. Do not send the form to this address. Instead, see Where To File.