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Department of <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, 1, <br />John Sinclair <br />(Name) <br />r <br />Fire Chief , for Kittitas County Fire Protection Dist 2 , do hereby certify to <br />(Title) (District Name) <br />the Kittitas <br />(Name of County) <br />County legislative authority that the Board of Fire Commissioners <br />(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 11/05/2015 <br />(Date of Public Hearing) <br />Regular Levy: $4,100,000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy: $463,100.00 <br />(State the total dollar amount to be levied) <br />Refund Levy: $0.00 <br />(State the total dollar amount to be levied) <br />Signature <br />NOV - E 201.5 <br />Date: 11/05/15 <br />For tax assistance or to request this document in an alternate format, visit http:Hdor.wa.gov/content/taxes/property/default.aspx <br />or call (360) 534-1400. Teletype (TTY) users may call (360) 705-6718. <br />REV 64 0100e (w) (10/12/10) <br />