Supplemental Information on Tax-Exempt Bonds

Form 990sk: Supplemental Information on Tax-Exempt Bonds

Use Tax Form 990sk: Supplemental Information on Tax-Exempt Bonds as a stand alone tax form calculator to quickly calculate specific amounts for your 2024 tax return. Alternatively you can use one of our Combined Federal and State Tax Estimator to quickly calculate your salary, tax and take home pay.

Supplemental Information on Tax-Exempt Bonds
Part I Bond Issues
(a) Issuer name		(b) Issuer EIN	(c) CUSIP #	(d) Date issued		(e) Issue price		(f) Description of purpose		(g) Defeased		(h) On behalf of issuer		(i) Pooled financing
A										Yes	No	Yes	No	Yes	No

B
C
D
Part II Proceeds
				A		B		C		D
1	Amount of bonds retired
2	Amount of bonds legally defeased
3	Total proceeds of issue
4	Gross proceeds in reserve funds
5	Capitalized interest from proceeds
6	Proceeds in refunding escrows
7	Issuance costs from proceeds
8	Credit enhancement from proceeds
9	Working capital expenditures from proceeds
10	Capital expenditures from proceeds
11	Other spent proceeds
12	Other unspent proceeds
13	Year of substantial completion
				Yes	No	Yes	No	Yes	No	Yes			No
14	Were the bonds issued as part of a current refunding issue?
15	Were the bonds issued as part of an advance refunding issue?
16	Has the final allocation of proceeds been made?
17	Does the organization maintain adequate books and records to support the final allocation of proceeds?
Part II Proceeds
				A		B		C		D
1	Was the organization a partner in a partnership, or a member of an LLC, which owned property financed by tax-exempt bonds?
2	Are there any lease arrangements that may result in private business use of bond-financed property?
Part III Private Business Use (Continued)
3a	Are there any management or service contracts that may result in private business use of bond-financed property?
b	If “Yes” to line 3a, does the organization routinely engage bond counsel or other outside counsel to review any management or service contracts relating to the financed property?
c	Are there any research agreements that may result in private business use of bond-financed property?
d	If “Yes” to line 3c, does the organization routinely engage bond counsel or other outside counsel to review any research agreements relating to the financed property?
4	Enter the percentage of financed property used in a private business use by entities other than a section 501(c)(3) organization or a state or local government			%		%		%		%
5	Enter the percentage of financed property used in a private business use as a result of unrelated trade or business activity carried on by your organization, another section 501(c)(3) organization, or a state or local government			%		%		%		%
6	Total of lines 4 and 5			%		%		%		%
7	Does the bond issue meet the private security or payment test?
8a	Has there been a sale or disposition of any of the bond-financed property to a nongovernmental person other than a 501(c)(3) organization since the bonds were issued?
b	If “Yes” to line 8a, enter the percentage of bond-financed property sold or disposed of			%		%		%		%
c	If “Yes” to line 8a, was any remedial action taken pursuant to Regulations sections 1.141-12 and 1.145-2?
9	Has the organization established written procedures to ensure that all nonqualified bonds of the issue are remediated in accordance with the requirements under Regulations sections 1.141-12 and 1.145-2?
Part IV Arbitrage
				A		B		C		D
1	Has the issuer filed Form 8038-T, Arbitrage Rebate, Yield Reduction and Penalty in Lieu of Arbitrage Rebate?
2	If “No” to line 1, did the following apply?
a	Rebate not due yet?
b	Exception to rebate?
c	No rebate due?
	If “Yes” to line 2c, provide in Part VI the date the rebate computation was performed
3	Is the bond issue a variable rate issue?
4a	Has the organization or the governmental issuer entered into a qualified hedge with respect to the bond issue?
b	Name of provider			%		%		%		%
c	Term of hedge			%		%		%		%
d	Was the hedge superintegrated?
e	Was the hedge terminated?
5a	Were gross proceeds invested in a guaranteed investment contract (GIC)?
b	Name of provider			%		%		%		%
c	Term of GIC			%		%		%		%
d	Was the regulatory safe harbor for establishing the fair market value of the GIC satisfied?
6	Were any gross proceeds invested beyond an available temporary period?
7	Has the organization established written procedures to monitor the requirements of section 148?
Part V Procedures To Undertake Corrective Action
	Has the organization established written procedures to ensure that violations of federal tax requirements are timely identified and corrected through the voluntary closing agreement program if self-remediation isn’t available under applicable regulations?
Part VI Supplemental Information. Provide additional information for responses to questions on Schedule K. See instructions

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