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druiiiiar? <br />Woshington State <br />Levy Certificafion <br />$ubmlt lhle documctlt to the county legislttivo ruthority on or befor* November 30 of the year precedingtte yenr in whlc[ the revy amoung sre to be collected <br />""na <br />rn"*rJ" .opy to it u r.."*ro., <br />ln accordance with RCW 94.52.020,1,Schrnidt <br />{Name) <br />(Title) <br />fbr Kitlilas Counrv Fire District I , do hereby certifi to <br />(DistrictName) <br />County legislative authori6r that thetheKittitas <br />(Name ofCounty) <br />Board of Commissioners <br />{fomnrissioncflsi cou.rc[ 8;m;;t- <br />of said district requests that the following levy amounts be collected in z[zl as provided in the district,s <br />(Yesr of Collection) <br />budget, which was adopted following a public hearing held on I <br />(Date of Public Hearing) <br />Regular Levy:.00 <br />(State the totel dollar amount t0 be lcvied) <br />Excess Levy:NO\J 75 <br />(State the totrl dollar amount to bc levied) <br />Refund Levy:i n! <br />L",,, <br />(Slatc the totrl dollar amount to be levied) <br />ft16 u <br />Signature;,.-. / 1/,'\ - <br />To_nsk abogt the rvailability of this publication in an altemare format for the visuallvTeletypc (1TY) uscrs, pruase cail (360) 705-67 r s. For rox assisran.., carr tiodj-s:i- <br />REV 64 0r00e (w) (22tlt2) <br />Date: 11124/20 <br />impaired, please call (360) 705-62lj <br />1400.