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RIl '1·I,HI"ll{ll\ of ~ evenue ~ <br />Wa shington Sto te <br />Levy Certification <br />Submit this document to the county legislative authority OD 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, William J. Powers Jr. ~~~~~~~~~-------------------------- <br />(Name) <br />Chairman, Board of Fire Commissioners • for <br />critic) <br />__ --=S:..:.n;.:o~g~u;.:.:ac:..:lmc:..:c:..:ie:....:;"P,;;;,a ;:.:ss:....:...F .:.;,ir..:..e...:&..:.....:Rc:..:e;.:s..:..c_=u ..:..e ___ . do hereby certify to <br />(District Name) <br />the Kittitas County legislative authority that the Board of Fire Commissioners --------~~~=----------(Name of County) (Colllmissioners. Council. Board. etc.) <br />of said district requests that the following levy amounts be collected in 2017 as provided in the district's ------(Year ol"('ollection) <br />budget, which was adopted following a public hearing held on 11110/16 <br />(Dale or Publk I karing) <br />Regular Levy : $300.000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy: $65,185 <br />(Stale the total dollar amount to be levied) <br />Refund Levy: $0 .00 <br />(Statl;: the total dollar amount to be levied) <br />Signature : Date: I f-If: -Zc(F <br />Dre -1 2016 <br />-/m <br />", t 1 <br />1'0 ns k ab Ollllh nvai ltt bilit o f thi s p lIblit.'t lioJl in till ,)l tcnl(II ' lo r mal ror Ih J I ·tm ll ~ !iifpui R I.,pl ca \;:b ll o(-36 0} 705- <br />67 15 . re let;.'p rTY) tn.'r .. pl l:!t ·c c'III ·( 60) 70. ·671 R. F~)r l a:"I · i L1lI1CI!'. cull (0) <i-I·IOO. ...'.', I • <br />IU·:V 64 o lODe (w) (2/21/12)