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Department of r� <br />Revenue <br />Washington State <br />Levy Certification <br />Submit this document to the county legislative authority on or before November 30 of the year preceding <br />the year in which the levy amounts are to be collected and forward a copy to the assessor. <br />In accordance with RCW 84.52.020, I, Brandi Taklo <br />(Name) <br />Clerk —.Jor the City of Roslyn , do hereby certify to <br />(Title) (District Name) <br />the Kittitas County legislative authority that the City Council <br />(Name of County) (Commissioners, Council, Board, etc.) <br />of said district requests that the following levy amounts be collected in 2016 as provided in the district's <br />(Year of Collection) <br />budget, which was adopted following a public hearing held on <br />Regular Levy: <br />Excess Levy: <br />Refund Levy: <br />$197,970.00 <br />(State the total dollar amount to be levied) <br />(State the total dollar amount to be levied) <br />(State the total dollar amount to be levied) <br />Signature: —& —)O -do <br />(R -Q-0 -P5JA <br />P i -2,5 <br />RV13 1l,, <br />>r QCW A <br />To ask about the ava <br />Teletype (TTY) user �09 <br />,� <br />REV 64 0100e (w) (2/21! <br />12/08/15 <br />(Date of Public Hearing) <br />DEC 2 8 2015 <br />Date: 16 -Az <br />V/6 - <br />he visually impaired, please call (360) 705-6715. <br />(360) 534-1400. <br />