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RSi?uffii8@ <br />Woshington Stote Levy Certification <br />RHCHIVHD <br />{ 't:'}fi.r'*..:- t. t i:i/.t,: <br />u,,,' !{iI i i,1i,offi ? L,, <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 84.52.02A.I,Cl'c*( I arf'c- Ga nzqleg <br />(l.Iume) <br />Kittitas Countv Fire Dist #4 .do hereby certi$r toffor <br />the <br />(Iitle) <br />Kittitas <br />@istrictName) <br />County legislative authority rhat the Commissioners <br />(Name of Coulty) <br />of said disfrict requests that the followrug levy amounts be collected in <br />(Cornmissioners, Corurcil, Board, eto.) <br />2021 as provided in the district's <br />fYeal ofCollection) <br />Date:ll- /7-zo <br />budget which was adopted following a public hearing held on t / * I 7- aA <br />(Dare of Public Hearing) <br />Regular Levy:+ <br />(State the total dollar amount to be.levied) <br />Excess Levy: <br />(State the tofel dollar amount to tre levied) <br />Refund Levy: <br />(State the total dollar arnount to be levied) <br />Signahue: <br />To ask about the availabilify of this publication in an alternate formar for the visually impaired, please call (360) 705-6715.Telefype (TTY) users, please call (360) 705-671g. For tax assisrance, call (360) sl+lqoo. <br />REV 64 0l 00e (w) (2/2t lt2)