Fillable GENERAL INFORMATION REPORT OF FINAL SALE West Virginia (State of West Virginia)

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GENERAL INFORMATION REPORT OF FINAL SALE West Virginia (State of West Virginia)

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WVSTO #:
REPORT OF FINAL SALE
West Virginia State Treasurer's Office
State Capitol Complex, Suite E-145
Charleston, WV 25305
(304) 558-5000
Completion of this form is requested to provide information which was not available when the "Report of Proposed Debt Issuance" was filed with the
Treasurer's Office or to verify information which was reported as "proposed." Additionally, please send a copy of the official statement (or offering
circular) with this form to the Treasurer's Office.
─────────────────────────────────────────────────────────────────────────────────────────────────────
GENERAL INFORMATION
NAME AND ADDRESS
OF ISSUER: _______________________________________________________________________________________________________________
ISSUE NAME: _____________________________________________________________________________________________________________
DATED : PRINCIPAL AMOUNT SOLD $
INTEREST COST: % (Please provide True Interest Cost)
Variable (Please specify.)
OFFICIAL STATEMENT: Enclosed To be sent None available
COMPLETE TRANSCRIPT: Enclosed To be sent None available
UNDERWRITER OR PURCHASER: __________________________________________________________________________________________
IS THE INTEREST ON THE DEBT EXEMPT FROM TAXATION?
Under State law: NO (taxable) YES (tax-exempt)
Under Federal law: NO (taxable) YES (tax-exempt)
If the issue is Federally tax-exempt, is interest a specific preference item for the purpose of alternative minimum tax?
Yes, preference item No, not a preference item
IS ANY PORTION OF THE DEBT FOR REFUNDING?
No Yes, amount of this issue (including costs) which is for refunding of existing debt $
ISSUANCE COSTS
Please indicate the parties involved and the applicable fees. An attachment may be provided in lieu of this form.
Special Bond Election ................................................................................................................. $
Bond Counsel .............................................................................................................................. $
Local Attorney ............................................................................................................................ $
Accounting/Auditing .................................................................................................................. $
Financial Advisor ........................................................................................................................ $
Bond Insurance ........................................................................................................................... $
Rating Agency #1 ....................................................................................................................... $
Rating Agency #2 ....................................................................................................................... $
Rating Agency #3 ....................................................................................................................... $
Preparation of Public Notice ....................................................................................................... $
O/S Publication Costs ................................................................................................................. $
Bond Printing Costs .................................................................................................................... $
Trustee Fees ................................................................................................................................ $
Signature Company Costs .......................................................................................................... $
Other (please indicate) ................................................................................................................ $
West Virginia State Treasurer's Office: Report of Final Sale
─────────────────────────────────────────────────────────────────────────────────
Page 2
CREDIT RATING
INDICATE CREDIT RATING: (For example, "AAA" or "Aaa")
RATED
Standard & Poor's: Fitch: ____________________________________
Moody's: Other: ____________________________________
NOT RATED
─────────────────────────────────────────────────────────────────────────────────────
CREDIT ENHANCEMENT
WAS THE ISSUE INSURED OR GUARANTEED? No Bond insurance Letter(s) of credit Other
GUARANTOR'S NAME:
─────────────────────────────────────────────────────────────────────────────────────
DISCOUNT/PREMIUM
The Bond was sold at: Par A Discount A Premium
If Bond was sold at a Premium, please indicate amount: $
If Bond was sold at a Discount, please indicate: Original Issue Discount $
Underwriter's Discount $
─────────────────────────────────────────────────────────────────────────────────────
MATURITY SCHEDULE
Please attach a maturity schedule for the bond issue if an official statement is not submitted with this form. Provide the following information:
1) Maturity Date 2) Principal Amount 3) Interest Rate
─────────────────────────────────────────────────────────────────────────────────────
OTHER INFORMATION
SOURCE OF FUNDS UTILIZED FOR REPAYMENT OF THE ISSUE:
Name of individual (representing Bond Counsel, Issuer, Financial Advisor, or Lead Underwriter) who completed this form and may
be contacted for information:
Name:
Firm/Agency:
Address:
Phone: Email Address:
Date of Completion:
Contact person at issuing agency, if different from above:
Name:
Title:
Address:
Phone: Email Address:
To submit this form, save it and email to Debt
Management@wvsto.com
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GENERAL INFORMATION REPORT OF FINAL SALE West Virginia (State of West Virginia)

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Completed 20 July 2020

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