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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 ~~~~~~------------------------------(Name) <br />______________ ~C~h~ie~f ______________ ,for ________ ---=F_i_re_D __ is:..c.t"-ri-'-c.:....t #_3:....-____ , do hereby certify to <br />(Title) (Di strict Name) <br />the Kittitas County legislative authority that the Commissioners ~~~~~~---------- <br />(Name of County) (Commissioners, Council, Board, etc.) <br />of said district requests that the foIlowing levy amounts be coIlected in 2018 / as provided in the district's <br />(Year of Collection) <br />budget, which was adopted following a public hearing held on 12/04/17 / : <br />(Date of Public Hearing) <br />Regular Levy: $74.130.00 ./ <br />OfC 14 (State the total dollar amount to be levied) <br />Excess Levy: $0.00 <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 />1 '-J tA~ ~ ~-'--Date: I '2 /0 'I j; 7 <br />------~~-- <br />To ask about the availability of this publication in an alternate format for the visually impaired, please call (360) 705-6715 . <br />Teletype (TTY) users, please call (360) 705-6718. For tax assistance, call (360) 534-1400. <br />REV 64 0100e (w) (2/21112)