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RDepar1men1 of ~ evenue ~ <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 fonvard a copy to the assessor. <br />In accordance with RCW 84.52.020, I, Jerica Pascoe .....;..."-"--'-'----'-'----'=---=~-'-----------------(Name) <br />Finance Director , for -----------------(Tit I e) <br />_____ C_ity.,.__o_f_E_l_le_n_sb_1_1r_..g.._ __ __,, do hereby certify to <br />(District Name) <br />the Kittitas County legislative authority that the Council --------------------------(Name of County) (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 following a public hearing held on 11/05/18 <br />(Date of Public Hearing) <br />Regular Levy: $3 200 000.00 <br />(State the total dollar amount to be levied) Nov 2 9 " <br />Excess Levy: $175 000.00 <br />(State the total dollar amount to be levied) <br />Refund Levy: <br />(State the total dollar amount to be levied) <br />Signature quC1AUlD \,uf__ Date: I \j 20\ 2D l £ <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 0I00e (w) (2/21/12)