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0 Department of ~ n:evenue ~ <br />Washington State Ordinance/ Resolution No. 11-04-19-03 <br />RCW 84.55.120 -------- <br />WHEREAS, the Board of Commissioners of Kittitas County Public <br />Hospital Dist 2/EMS <br />(Name of the taxing district) <br />has met and considered <br />(Governing body of the taxing district) <br />its budget for the calendar year ; and, -----2020 <br />WHEREAS, the districts actual levy amount from the previous year was $ 676,1,92.-37 ; and, <br />-:::-"""7""-----'-..,.....-e---~ (Previous year's levy amount) <br />WHEREAS, the population of this district is !ZI more than. or D less than 10,000; and now, therefore, <br />(Check one) <br />BE IT RESOLVED by the governing body of the taxing district that an increase in the regular property tax levy <br />is hereby authorized for the levy to be collected in the · 2020 tax year. <br />(Year of collection) <br />The dollar amount of _the increase over the actual levy amount from the previous year shall be $ 6,761.92 <br />which is a percentage increase of 1.0 % from the previous year. This increase is exclusive of <br />(Percentage increase) <br />additional revenue resulting from new construction, improvements to property, newly constructed wind turbines, <br />solar, biomass, and geothermal facilities, and any increase in the value of state assessed property, any annexations <br />that have occurred and refunds made. <br />Adopted this +-day of _.,..:.d'--'1'--'i'-) ____ , --Mot .J . <br />If additional signatures are necessary, please attach additional page. <br />This form or its equivalent must be submitted to your county assessor prior to their calculation of the property tax <br />levies . A certified budget/levy request, separate from this form is to be filed with the County Legislative Authority <br />no later than November 30th• As required by RCW 84.52.020, that filing certifies the total amount to beJevied by <br />the regular pr9perty 1aX levy. The Department of Revenue provides the "Levy Certification'' form (REV 64 0100) <br />for this purpose. The form can be found at: http://dor.wa.gov/docs/fonns/PropTx/Forms/LevyCertfdoc. - <br />To ask about the availability of this publication in an alternate fonnat, please call l-800-647-7706. Teletype (TTY) users may <br />use the Washington Relay Service .by calling 711. For tax assistance, call (360) 534-1400. <br />REV 64 0!0le (w) (12/9/14)