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*ffi,i1,#4,9 Levy Certification <br />submit this document to the county regisrative a'thority on or before Novemhrr 30 of the year precedingthe year in which the levy amounts are to be collected <br />"ira io"tm.J I .opy to the assessor. <br />In accordance with RCW 84.52.020,1,Jeann ine Lavande <br />(Namc) <br />Secrctary , fbr Kinitas Co. Fire protectiol Disirict 6 , do hcreby certifu tol0) <br />(Titte)(Dishict Name) <br />County legislative authority that the <br />Signature |L-/'-Date n />4 bo <br />the Kittitas of Fire Comm <br />{Name of Counry)(Commissioners. Council, Board. etc_) <br />of said dist|ict requests that the following levy amounts bc collected in z02l as provided in the district,s <br />(year of Collcction) <br />budget, which was adopted following a public hearing held on It/10t20 : <br />(Datc of Public Ilearing) <br />RegLrlar Levy: $j t5,000,00 <br />(Statc the total doll:r amount to be levied) <br />Excess Levy s0 NrJV 3: <br />(State the totrl dol Iar arnount ro be levied) <br />Refund Levy:$r.s2 <br />(State the total dollar an'|ount to be levied) <br />To ask about the availabiliry of this publication in an altemate formar forthe visually impaired, please call (360) 705-6715Teletype(TTY)users,preasecall(3'60)705-671g. Fortaxassistance,call(360) s34-1400. <br />REV 6a 010(le (*vl (2t2t/t2l