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RDepartm e nt of ~ evenu e ~ <br />Washington State <br />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, -=D--=-ia=n;::..:e'--'E=w-'-'--"-in:.;:<g::>....-____________________________ _ <br />(Name) <br />____________ ~S~e~cr~e~ta~ry~ ___________ )for _---=K:..::l:..:.· t:..:.ti:..:.ta:..:.s_C::..o.:...u~n:.:..:t""_y....:F:..::i.:...re:....D:::....:.;is:..:.t::..:ri:..::ct.:...#:.:...8=____, do hereby certify to <br />(District N arne) (Title) <br />the Kittitas County legislative authority that the Fi re ----------------------~~~~~~~:.:...::..-------------(Name of County) (Commissioners, Council, Board, etc.) <br />of said district requests that the following levy amounts be collected in 2018 as provided in the district's <br />(Year of Collection) <br />budget, which was adopted following a public hearing held on 11/30/17 <br />(Date of Public Hearing) <br />Regular Levy: $107,477.32 <br />(State the total dollar amount to be levied) <br />Excess Levy: -IJJ. J 4-'3 1 2 --UtuP 2:0 _____ <br />(State the total dollar amount to be levied) 0 <br />BPflc.L <br />~-Levy: <br />(State the total dollar amount to be levied) <br />Signahrre: /J<au tl ~ --Date: 11/30117 <br />DEC 1 Z 7.017 <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 OIOOe (w) (2/21112)