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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, Steve Jensen ~~~~~~------------------------------(Namel <br />______________ C~~~h ~ie~f ______________ .for _______ ......;F....:,i.:...;re:...:D..:.:i:.;:l:...,:ri.=,l.:=-l #;;.;3~ _______ . do hereby certifY to <br />( ['ilk) (Di strict Name) <br />the Kittitas County legislative authority that the Commissioners ~~~~~~~--------------(Name ofeounty) (Commissiuners. Council. Board. ct.:.) <br />of said district requests that the following levy amounts be collected in 2017 as provided in the district's <br />(Year orColiection) <br />budget, which was adopted following a public hearing held on 1217/16 <br />(Date of Public lIearing) <br />Regular Levy: $71,000.00 <br />(Statt: the total dollar lImount 10 be levied) <br />Excess Levy; $0.00 <br />(State the total dollar amount to be h:vicd) <br />Refund Levy: $0 .00 <br />(State the total dollar amnunl to be Inicd) <br />i <br />Signature: J. u.. o <br />Date: J -1 . ",. <br />To ask about the availability of this publication in an alternate format for the visually impaired, please call (360) 705-671 S. <br />Teletype (TTY) users , please call (360) 705-6718 . For tax assistance. call (360) 534-1400. <br />REV 64 OIOOc (wt (2 121 1Il)