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0 D partrnent of (@ nevenue ~ <br />Washington State <br />Levy Certificatio.n <br />~~i~cl-- <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, _N;;..;.;;.;a;;.;;na=D ... v_;;,;k;__ ______________ _ <br />(Name) <br />________ C_le_r_k ______ ~ for Kittitas County emetery District# 1 , do hereby certify to <br />(Title) (District Name) <br />the Kittitas County legislative authority that the Commissioners ---------'--------------------(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 11/09/18 <br />(Date of Public Hearing) <br />Regular Levy: $15 000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy: <br />(State the total dollar amount to be levied) <br />Refund Levy: <br />(State the total dollar amount to be levied) <br />Signature: .,, Date: 11-27-2018 <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 0l00e <w) (2/21/12)