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TAX RETURN FOR $20000 BOND Co'solidated Information Return f~r Small Tax-Exempt Governmental Bond Issues ~ Under Section 149(e) ~ For calendar year ending 19 __ __ _, (Use Form 8038-G If issue price of the issue is $100,000 or more.) Check box if Amended Return . ;orm 8038-GC (May 1987) Department of the Treasury Internal Revenue Service Reporting Authority 1 Issuer's name City of Clearwater 3 Number and street 1900 Grand Avenue 4 City or town, state, and ZIP code Clearwater, FL 34625 Description of Bonds OMS No. 1545,0720 Expires 02/28/90 ~ 0 2 Issuer's employer identification number 5 Total issue price of all bonds issued as part of an issue, the issue price of which is less than $100,000 6 Check box that most nearly approximates the weighted average maturity of the bonds: a D Less than 5 years b [i] From 5 to 10 years c D More than 10 years 7 Check box that most nearly approximates the weighted average interest rate on the bonds: a D Less than 5% b D From 5% to 10% c [XJ More than 10% 8 Total issue price of the bonds reported on line 5 that are: a Bonds issued in the form of a lease or installment sale, b Bonds designated by the issuer under section 265(b)(3)(B)(ii) c Bonds issued to refund prior issues . 8a 20,000 00 8b 8e Please Sign Here d Loans made from the proceeds of another tax-exempt bond issue 8d Under penalties of periury, 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~OmPI!!. jG /~~,,. /. j........ ~ V 7, CL I /,(--<_~, U-<, .v ,. Signature of officer j' General Instructions (Section references are to the Internal Revenue Code unless otherwise noted.) Changes You Should Note All issuers of tax-exempt bonds must report certain information about bonds they issue. Issuers should use Form 8038-GC only if the issue price of the issue is under $100,000. If the issue price is $100,000 or more, issuers should use Form 8038-G, Information Return for Tax-Exempt Governmental Bond Issues. For private activity bonds, issuers should use Form 8038, Information Return for Tax-Exempt Private Activity Bond Issues. Paperwork Reduction Act Notice We ask for this information to carry out the Internal Revenue laws of the United States. We need it to ensure that you are complying with these laws. You are required to give us this information. v""'" 4 / 1 ? / gO ~ / Ac ting:!..City ~Manager Date ,. Title Definitions . A tax-exempt bond is an obligation issued as part of an issue the interest on which is exempt from tax under the Internal Revenue Code. . A tax-exempt governmental bond is a tax-exempt bond that is not a private activity bond. . A private activity bond is generally a bond issued as part of an issue of which: (1) more than 10% of the proceeds are to be used for any private business use; and (2) more than 10% of the payment of the principal or interest either is secured by an interest in property to be used for a private business use (or payments in respect of such property) or is to be derived from payments in respect of property (or borrowed money) used for a private business use. A bond will also be considered a private activity bond if the amount of the proceeds to be used to make or finance loans (other than loans Purpose of Form Form 8038-GC is to be used by issuers of tax-exempt governmental bonds to provide IRS with the information required by section 149(e) and to monitor the requirements of sections 141 through 150. Who Must File Each issuer must file a single Form 8038-GC for all tax-exempt governmental bond issues issued after December 31,1986, with issue prices of less than $100,000. Form 8038-G is filed to report each issue of governmental bonds with issue prices of $100,000 or more. When To File File Form 8038.GC on or before Februilry 15th after the close of the calendar year in which the issue is issued. Form 8038-GC must be completed based on the facts as of the close of the calendar year. Where To File File Form 8038-GC with the Internal Revenue Service Center, Philadelphia, PA 19255. Form 8038-GC (5-87) (1.1) . y I I May 22, 1990 Ms. Kathy Rice, Acting city Manager city of Clearwater 1900 Grand Avenue Clearwater, FL 34625 Dear Ms. Rice: In processing your Lease for your telephone system, we find that there is a difference in the "System Price". This is a result of equipment changes made subsequent to the signing of your Lease. A copy of your Lease is enclosed. We ask that you read the terms of your Lease, specifically "OTHER TERMS" #5. Because of the greater than 10% difference, GTE Leasing corporation will not initiate the changes stated at the bottom of this letter without your signature authorizing such changes. It is imperative that the same person who signed our documents sign at the bottom of this letter and return to us as soon as possible. Your first invoice will reflect this amount. We appreciate the opportunity to serve your leasing needs and if we can be of further service to you, or answer any questions regarding your Lease, please do not hesitate to call our office. Sincerely, GTE LEASING CORPORATION Dan Hathcoat District Credit Manager ORIGINAL SYSTEM PRICE (INSTALLATION INCLUDED): $ 20.000.00 TERMS: 60 months @ $ 434.00 AMENDED SYSTEM PRICE (INSTALLATION INCLUDED): $ 23.146.02 TERMS: 60 months @ $ 502.27 ~ TITLE: A(.t:~J (:+1 fV\JV" DATE: 5~d:J. 7'0