The URL can be used to link to this page

Home My WebLink About8038-G Info Return for Tax Ex Governmental Bonds Form 8038-G Information Return for Tax-Exempt Governmental Bonds lo-Under Internal Revenue Code section 149(e) (Rev.September 2018) 0-See separate instructions. OMB No.1545-0720 Department of the Treasury Caution:If the issue price is under$100,000, use Form 8038-GC. Internal Revenue Service ►Go to www.irs.gov/F8038G for instructions and the latest information. KOM Reporting Authority If Amended Return, check here ► ❑ 1 Issuer's name 2 Issuer's employer identification number(EIN) Town of Southold 11-6001939 3a Name of person(other than issuer)with whom the IRS may communicate about this return(see instructions) 3b Telephone number of other person shown on 3a 4 Number and street(or P O.box if mail is not delivered to street address) Room/suite 5 Report number(For IRS Use Only) 53095 Main Road 13 6 City,town,or post office,state,and ZIP code 7 Date of issue Southold New York 11971 9/24/19 8 Name of issue 9 CUSIP number $9,279,117 Bond Anticipation Note-2019 844572 QX8 10a Name and title of officer or other employee of the issuer whom the IRS may call for more information(see 10b Telephone number of officer or other instructions) employee shown on 10a Kristie Hansen-Hightower,CPA,Comptroller (631)765-4333 Type of Issue (enter the issue price). See the instructions and attach schedule. 11 Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 12 Health and hospital . . . . . . . . . . . . . . . . . . . . . . . . . . 12 13 Transportation . . . . . . . . . . . . . . . . . . . . . . . . . . 13 14 Public safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 15 Environment (including sewage bonds) . . . . . . . . . . . . . . . . . . . 15 16 Housing . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 17 Utilities . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 18 Other. Describe ► Various Capital Projects 18 19a If bonds are TANs or RANs, check only box 19a . . . . . . . . . . . . . . . ► ❑ I b If bonds are BANS,check only box 19b . . . . . . . . . . . . . . . . . . ► ® i 20 If bonds are in the form of a lease or installment sale, check box ► ❑ Description of Bonds. Complete for the entire issue for which this form is being filed. (a)Final maturity date (b)Issue price (c)Stated redemption (d)Weighted (e)Yield price at maturity average maturity 21 $ $ years % IM Uses of Proceeds of Bond Issue (including underwriters' discount) 22 Proceeds used for accrued interest . . . . . . . . . . . . . . . . . . . . . 22 000 23 Issue price of entire issue(enter amount from line 21, column(b)) . . . . 23 000 24 Proceeds used for bond issuance costs(including underwriters' discount) 24 25 Proceeds used for credit enhancement . . . . . . . . . . . . 25 000 26 Proceeds allocated to reasonably required reserve or replacement fund . 26 000 27 Proceeds used to refund prior tax-exempt bonds. Complete Part V. . . 27 00 28 Proceeds used to refund prior taxable bonds Complete Part V . . . . 28 000 29 Total(add lines 24 through 28) . . . . . . . . . . . . . . . . . . . . . . . 29 000 30 Nonrefunding proceeds of the issue(subtract line 29 from line 23 and enter amount here) 30 000 Description of Refunded Bonds. Complete this part only for refunding bonds. 31 Enter the remaining weighted average maturity of the tax-exempt bonds to be refunded . . . ► years 32 Enter the remaining weighted average maturity of the taxable bonds to be refunded . . . . ► years 33 Enter the last date on which the refunded tax-exempt bonds will be called (MM/DD/YYYY) ► 34 Enter the date(s)the refunded bonds were issued►(MM/DD/YYYY) For Paperwork Reduction Act Notice,see separate instructions. Form 8038-G(Rev.9-2018) ISA Form 8038-G(Rev 9-2018) Page 2 Miscellaneous 35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . . . 35 36a Enter the amount of gross proceeds invested or to be invested in a guaranteed investment contract '(GIC). See instructions . . . . . . . . . . . . . . . . . . . . . . . . . 36a b Enter the final maturity date of the GIC►(MM/DD/YYYY) c Enter the name of the GIC provider► 37 Pooled financings: Enter the amount of the proceeds of this issue that are to be used to make loans to other governmental units . . . . . . . . . . . . . . . . . . . . . . . . 37� 38a If this issue is a loan made from the proceeds of another tax-exempt issue,check box► ❑ and enter the following information: b Enter the date of the master pool bond►(MM/DD/YYYY) c Enter the EIN of the issuer of the master pool bond► d Enter the name of the issuer of the master pool bond Do- 39 39 If the issuer has designated the issue under section 265(b)(3)(13)()(III)(small issuer exception), check box . . . . ► ❑ 40 If the issuer has elected to pay a penalty in lieu of arbitrage rebate, check box . . . . . . . . . . . . . ► ❑ 41a If the issuer has identified a hedge, check here► ❑ and enter the following information: b Name of hedge provider► c Type of hedge 10- d d Term of hedge 10- 42 42 If the issuer has superintegrated the hedge, check box . . . . . . . . . . . . . . . . . . . . . ► ❑ 43 If the issuer has established written procedures to ensure that all nonqualified bonds of this Issue are remediated according to the requirements under the Code and Regulations(see instructions),check box . . . . . . . . 111,- 44 44 If the issuer has established written procedures to monitor the requirements of section 148,check box . . . . . ► 45a If some portion of the proceeds was used to reimburse expenditures,check here► ❑ and enter the amount of reimbursement . . . . . . . . . . . . . . 10- b b Enter the date the official intent was adopted►(MM/DD/YYM Under penalties of penury,I declare that I have examined this return and accompanying schedules and statements,and to the best of my knowledge Signature and belief,they are true,ccect,and complete.I further declare that I consent to the IRS's disclosure of the issuer's return information,as necessary to and process this return,to th erson that 1 e authorized above. Consent Q� 04 9/24/19 'Scott A.Russell, Supervisor Signature i e-es authorized representative Date Type or print name and title Paid PnntlType preparer's name Preparer's signature Date Check ❑ if PTIN Pself-employed p01085234 reparer Robert P. Smith Use Only Firm's name ►Hawkins Delafield&Wood LLP Firm's EIN 1,.13-5513990 Firm's address ►7 World Trade Center,250 Greenwich Street New York NY 10007 Phone no 212 820-9400 Form 8038-G(Rev.9-2018)