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R3ir6ffiE@ <br />Woshingon Stote <br />Levy Certification <br />Submit this document to the county legislative authority 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 />In accordance with RCW 84.52.020,I,Debbie Lee <br />(Name) <br />Cled,/Treasurer for Citv of Kittitas do hereby certify to <br />the <br />(Title) <br />Kittitas <br />(District Name) <br />County legislative authority that the City Council <br />(Name of County)(Commissioners, Council, Board, etc.) <br />of said district requests that the following levy amounts be collected in z02l as provided in the district's <br />(Year of Collection) <br />budget, which was adopted following a public hearing held on 1l <br />(Date of Public Hearing) <br />Regular Levy:00 <br />(State the total dollar amount to be levied) <br />Excess Levy: <br />(State the total dollar amount to be levied) <br />Refund Levy:96.85 <br />(State the total dollar amount to be levied) <br />Signature:Date: lll24l20 <br />To ask about the availability of this publication in an alternate format for the visually impaired, please call (360) 705-6? l5Teletype (TTY) users, please call (360) 70s-6718. For tax assistance, call (360) s:4-t+tjo. <br />REV 64 0100e (w) (2/2t/12)