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~ DEPAllnIENT OF REvENUE <br />WAllfitHn'oH STA1J! Levy Certification NOV 2 9 <br />Submit this document to the county legislative authority on or before November 30 of the year preceding <br />the year in which tbe levy amounts are to be collected and fonvard a copy to the assessor. <br />In accordance with RCW 84.52.020. I. -,o=eb::,:b:.:,;ie=-· =L:.,:. L:::.;e:.::e:....-__ ~---:---: ________ _ <br />(Nome) <br />_____ ..::C::.:l.::er:.::kff~r:_=e:.:a::.:su:.:r,;.e:...r _____ • for ____ --=C:..::;it:.l.y...;o;.;:f~Kc=i:.:;tl:.:;it:.::a:=.s ____ , do hereby certify to <br />(Title) (District Nllme) <br />the ___ ,_~K.::i:.:.:tt:::it=as;..... ____ County legislative authority that the _C:;.;I:..:.·tyL.....;;;C~o=uD;;.;c:.:.i:...1 _______ _ <br />(Nome of County) (Commissioners, Council, BOllrd. elc.) <br />of said district requests that the following levy amounts be collected in 2018 as provided in the district's <br />(Y CIIr of Collection) <br />budget, which was adopted following a public hearing held on 11128/17 <br />(Date of Public HCllring) <br />Regular Levy: $180,000.00 <br />(State the total dollllr IImount to be levied) <br />Excess Levy: <br />(SIOle the total dollur omounllo be levied) <br />Signature: Date: 1l/28/20 I 7 <br />For tax assistance, visit hctp :Jfdor.wll .gov or call 1-800-647-7706. To inquire about the availability or this document in an <br />alternate fonnat for the visually impaired, please call (360) 705-6715. Teletype (1TY) usel1l may call 1-800451-7985. <br />REV 64 OI00c(w)(IOI26/0S)