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DEraRTi►rIEN r <br />OF <br />ASHIkGTpN <br />AS REVENUE Levy Certification <br />WSTATE <br />Submit this document to the county legislative autharity 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, Debbie L. Lee <br />(Name) <br />ClcrldTreasurer , for Citv of If ittila5 , do hereby certify to <br />(Title) <br />(District Name) <br />the Kittitas County legislative authority that the SiCouncil <br />(Mame of County) <br />(Commissioners, Council, Board, etc,) <br />of said district requests that the following levy amounts be collected in 2019 as provided in the district's <br />(Year of Collection) <br />budget, which was adopted fallowing a public hearing held on <br />Regular Levy: $180)Ut).00 <br />(state the total dollar amount to be levied) <br />Excess Levy: <br />(State the total dollar amount to be 1-icd) <br />(Date of Public Hearing) <br />I�j <br />Signature: f <br />Date: <br />For tar assistance, visit ht L r,wa. av or call 1-800-647-7706. To in({wire allout the availability of this documctlt in an <br />alternate fonnat for the visually unpaired, please call (360) 705-6715. Teletype (TTY) users may call 1400451-7985. <br />REV 64 01 OOe (w) (IOR6105) <br />