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Rafffiilt@ Levy Certification <br />Submit this document, or something similar, to the county legislative <br />authority on or before November 30 of the year preceding the year in which <br />the levy amounts are to be collected. <br />Courtesy copy may be provided to the county assessor. <br />This form is not designed for the certification of levies under RCW 84.52.070. <br />o <br />Woshington Stote <br />ln accordance with RCW 84.52.020,1 Eryn A Micallef @ame), <br />District Secretary ffiile),1or Kittitas County Fire Protection District No. 7 (District nome), <br />do hereby certify to the Kittitas (Name of county) County legislative authority <br />that the commissioners Pommissioners, Council, Board, etc.) of said district requests <br />that the following levy amounts be collecls6 ;n 2022 (Yeor of collection) as provided in the district's <br />budget, which was adopted following a public hearing held on tlltol2Ozl pote of public hearing). <br />lar levies <br />Excess levies <br />*Examples of other levy types may include EMS, school district transportation, or construction levies. <br />Examples of amounts may include levy error correction or adjudicated refund amount. Please include <br />a descri <br />Signatu <br />To req <br />or call <br />t <br />re: <br />uest this ument in a Iternate <br />360-705-6705. Teletype (TTY) users please dial 71 1. <br />Date: <br />at, please complete the form clor.wa.qov/Accessi hi I ityReq uest <br />n JrD luzt <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />s 3,250,000.00 <br />Administrative refund a mount <br />Non-voted bond debt amount <br />Other* <br />General levy Other levy*Levy <br />Totalcertified levy <br />request amount, <br />which includes the <br />amounts below. <br />!-- <br />Administrative refund <br />amount <br />Other* <br />General <br />(n/a for school <br />d istricts) <br />Enrichment <br />(school <br />districts only) <br />Other <br />Bond Cap. projectLevy <br />REV 64 0700 (8/27/2L)Page 1 of 1