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Form 8038.0(Rev.9-2011) Page 2 Part VI Miscellaneous 35 Enter the amount of the state volume cap allocated to the issue under section 141(b)(5) . . . 35 0 36a Enter the amount of gross proceeds invested or to be invested In a guaranteed Investment contract (GIC)(see instructions) 36a 0 b Enter the final maturity date of the GIC► c Enter the name o1 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 0 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 obligation► c Enter the EIN of the issuer of the master pool obligation► d Enter the name of the issuer of the master pool obligation► 39 If the issuer has designated the issue under section 265(b)(3)(B)()(III)(small issuer exception),check box . . ► El 40 if the issuer has elected to pay a penalty in lieu of arbitrage rebate,check box ► LI 41a If the issuer has identified a hedge,check here► ❑ and enter the following Information: b Name of hedge provider► c Type of hedge► d Term of hedge► 42 If the issuer has superintegrated the hedge,check box ► El 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 ► 0 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 ► b Enter the date the official Intent was adopted► Under penalties of perjury,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,correct,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 the pe on that I have authorized above. Consent 0116.4 A 4 .l. "Am -.�./ . - I�� _ . / . I: ._ - '_,�. i Signatu of Issu 1's a '• zed r .esentative Date Type or print name and title Paid Print/Type prepares's name Preparer's signature Date check 1:1 it PTIN Preparer Robert Starin salt-employed P01485649 Use Only Firm's name ► K&L Gales LLP Firm's EIN ► 250921018 Firm's address► 925 Fourth Avenue,Suite 02900,Seattle,WA 98104-1158 Phone no. 206-623-7580 Form 8038-G(Rev.9-2011) •