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Rerenu ef@ <br />Wa shington 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, William J. Powers Jr. ---------------------(Name) <br />Chairman, Board of Fire Commissioners , for <br />(Title) <br />__ S_n_o~g_u_a_lm_i_e_P_a_s_s_F_ir_e_&_R_e_s_c_u_e_~• do hereby certify to <br />(Di strict Name) <br />the Kittitas County legislative authority that the Board of Fire 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 11/20/18 <br />Regular Levy: <br />Excess Levy: <br />Refund Levy: <br />Signature: <br />(Date of Public Hearing) <br />$450 000 <br />(State the total dollar amount to be levie~) l <br />i=~.te S-1 ui-G,o Co .1's.L ~4 : $ 67, 7-41.s:O <br />$ 43 Z~Z-~O ~,e <e> l.JT &O ~4Pj~..,.Ct.k - <br />I <br />(State the total dollar amount to be levied) <br />$0.00 <br />(State the total dollar amount to be levied) <br />Date: J(-Z(l-{/ <br />To ask about the availabil ity of this publication in an alternate format for the visually impaired, please call (360) 705- <br />6715. Teletype (TTY) users, please call (360) 705-6718. For tax assistance, call (360) 534-1400 . <br />REV 6 4 OlOOe (w) (2/21 /12 )