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Form 803 8 -G Information Return for Tax-Exempt Governmental Obligations <br />(Rev . September 2011 ) <br />Department of the Treasury <br />Internal Revenue Service <br />~ Under Internal Revenue Code section 149(e) <br />~ See separate instructions. <br />OMS No . 1545-0720 <br />Caution: If the issue price is under $1 00,000, use Fo rm B03B-G C. <br />1 Issuer's name <br />.COUIl 91-6001349 <br />3a <br />Julie <br />person (other than issuer) with whom the IRS may communicate about this return (see instructions) <br />k, Clerk of the Board <br />3b Telephone number of other person shown on 3a <br />4 Number and street (or P.O. box if mail is not del iv ered to street address) <br />205 West 5th Avenue <br />6 City , town, or post office, state, and ZIP code <br />WA 98926 <br />Lease Purchase ll11m •• m,.nt No.7768 <br />Room/suite <br />105 <br />10a Name and title of officer or other employee of the issuer whom the IRS may call for more information (see <br />instructions) <br />Jerald V. Pettit, County Auditor <br />11 <br />12 <br />13 Transportation . <br />14 Public safety. <br />15 Environment (including sewage bonds) <br />16 Housing <br />17 Utilities <br />509-962-7557 <br />5 Report number (For IRS Use <br />7 Date of issue <br />05/17/2017 <br />9 CUSIP number <br />None <br />1 Db Telephone number of officer or other <br />employee shown on 10a <br />509·962·7557 <br />18 Other. Describe ~ Election Equi pment ~--~~~------------------------------------------~ 19 If obligations are TANs or RANs, check only box 19a <br />If obligations are BANs , check only box 19b <br />20 If obligations are in the form of a lease or installment sale , check box <br />23 Issue price of entire issue (enter amount from line 21, column (b)) <br />24 Proceeds used for bond issuance costs (including underwriters ' d iscount) . <br />25 Proceeds used for credit enhancement . <br />26 Proceeds allocated to reasonably required reserve or replacement fund <br />27 Proceeds used to currently refund prior issues <br />28 Proceeds used to advance refund prior issues <br />29 Total (add lines 24 through 28) . 29 N/A <br />30 ceeds of the is s ue <br />31 Enter the remaining weighted average maturity of the bonds to be currently refunded . ~ N/A years <br />32 Enter the remaining weighted average maturity of the bonds to be advance refunded ~ N/A years <br />33 Enter the last date on which the refunded bonds will be called (MM/DDIYYYY) ~ N/A <br />34 Enter the date(s) the refunded bonds were issued ~ (MM/ODIYYYY~ <br />For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 63773S Form 8038-G (Rev . 9-2011)