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REvuftii 6@ <br />Washingtan State <br />Levy Certification <br />Submit this document to the county legislative althority on or before November 30 of the year precedingthe year in which the levy amounts are to be collected and forward a copy to the assessor. <br />ln accordance with RCW 84.52.020,1, Jeannine Lavande <br />(Name) <br />Secretary , for Kittitas Co. Fire protection District 6 , do hereby certify to(#64001 0) <br />(Tirte)(District Name) <br />the Kittitas County legislative authority that the Board of Fire Comm lsslOners(Name of County)(Commissioners. Council, Board. etc.) <br />of said district requests rhat the foilowing levy amounts be collected in z02l as provided in the district's <br />(Year of Collection) <br />tt/10t20 : <br />(Date of Public Hearing) <br />Regular Lely $3 rs 00 <br />(State the total dollar amount ro be levied) <br />budget, which was adopted following a public hearing held on <br />Excess Levy $0.00 <br />(State the tot.tl-G-*o*r toG t*i.ay <br />Refund Levy: $1.52 <br />(State the total dollar anrount to be levied) <br />Signature L-x- <br />I i:;1.:..,.. : <br />N(]V 3I <br />Date: <br />.,r,r, I i;,i,i.ir, <br />it b4bo <br />To ask about the availability of this publication in an altemate fbrmat forthe visually impaired, please cail (360) 705-6715.Teletype (TTY) users, prease call (360) 705-671g. For rax assistance, *rr i:ool 534-r4a0. <br />REv 64 0100e (w) {2/zt/12)