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~venue Levy Certification OCT 1 4 ?n16 <br />Washington State <br />Submit this document to the county legislative authority on or before November 30 ofthe.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, John Sinclair <br />(Name) <br />______ ---"-F.::ir...:.e...,;C::..:h;,:.:i...:.e;:,.f _____ ----J. for Kittitas County Fire Protection Dist 2 ,do hereby certify to <br />(Title) (District Name) <br />the Kittitas County legislative authority that the Board of Fire Commissioners -------------(Name of County) (Commissioners, Council, Board, etc.) • <br />of said district requests that the following levy amounts be collected in 2017 as provided in the district's <br />(Year of Collection) <br />budget, which was adopted following a public hearing held on 10/13/2016 <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: Date: 10113116 <br />For tax assistance or to request this document in an alternate format, visit http://dor.wa .gov/contentltaxeslpropertvldetault.aspx <br />or call (360) 534-1400. Teletype (TTY) users may call (360) 705-6718. <br />REV 64 OIOOe (w) (10/12/10)