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REVEfrriii E@ <br />Woshingon Stote <br />Levy Certification <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 84.52.020,I,Ervn A Mical lef <br />(Name) <br />District Secretary/ Finance Admin , for Kittitas Protection , do hereby certifu to <br />1 <br />(Title)(District Name) <br />County legislative authority that the Commissioners <br />(Commissioners, Council, Board. etc.) <br />2021 as provided in the district's <br />(Year of Collection) <br />Date: llllIl2020 <br />the <br />(Name of County) <br />of said district requests that the following levy amounts be collected in <br />budget, which was adopted following a public hearing held on tlny20 <br />(Date of Public Hearing) <br />Regular Levy:$3. I 00.000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy: <br />Refund Levy: <br />Signature: <br />(State the total dollar amount to be levied) <br />(State the total dollar amount to be levied) <br />NOV 17 "'''. <br />itll.. <br />To ask about the availability of this publication in an altemate format for the visually impaired, please call (360) 705-6715. <br />Teletype (TTY) users, please call (360) 705-6718. Fortax assistance, call (360) 534-1400. <br />REV 64 0100e (w) (2l2ll12)