SCHEDULE K
(Form 990)
Department of the Treasury
Internal Revenue Service
Supplemental Information on Tax-Exempt Bonds
Complete if the organization answered “Yes” on Form 990, Part IV, line 24a. Provide descriptions,
explanations, and any additional information in Part VI.
Attach to Form 990.
Go to www.irs.gov/Form990 for instructions and the latest information.
OMB No. 1545-0047
2019
Open to Public
Inspection
Name of the organization Employer identification number
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
Yes No Yes No Yes No
A
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 refunding issue of tax-exempt bonds (or,
if issued prior to 2018, a current refunding issue)? . . . . . . . . .
15
Were the bonds issued as part of a refunding issue of taxable bonds (or, if
issued prior to 2018, 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? . . . . . . . . . . . . . . . .
For Paperwork Reduction Act Notice, see the Instructions for Form 990.
Cat. No. 50193E Schedule K (Form 990) 2019
Schedule K (Form 990) 2019
Page 2
Part III Private Business Use
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? . . . . . . . .
Yes No Yes No Yes No Yes No
2 Are there any lease arrangements that may result in private business use of
bond-financed property? . . . . . . . . . . . . . . . . . .
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? . . . . . . . . . . . . . .
Yes No Yes No Yes No Yes No
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? . . . . . . . . . . . . .
Schedule K (Form 990) 2019
Schedule K (Form 990) 2019
Page 3
Part IV Arbitrage (continued)
A B C D
4a
Has the organization or the governmental issuer entered into a qualified
hedge with respect to the bond issue? . . . . . . . . . . . . .
Yes No Yes No Yes No Yes No
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
A B C D
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? . . . . . . . . . . . . . . . . . .
Yes No Yes No Yes No Yes No
Part VI Supplemental Information. Provide additional information for responses to questions on Schedule K. See instructions
Schedule K (Form 990) 2019
Schedule K (Form 990) 2019
Page 4
Part VI
Supplemental Information. Provide additional information for responses to questions on Schedule K. See instructions (continued)
Schedule K (Form 990) 2019