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Rav6fr"tru (? <br />Woshington Stote <br />WIIEREAS, the Board of Commissioners of <br />(Governing body ofthc taxing district) <br />Ordinance / Resolution No. zt-os <br />RCW 84.55.120 <br />Kittitas County Public <br />Hospital District No. I <br />(Namc of the taxing district) <br />has met and considered <br />its budget forthe calendar year 2022 ; and, <br />WHEREAS, the districts actual lely amount from the previous year was $9,507.66 ; and, <br />@rcvious year's lcly amount) <br />WIIEREAS, the population of this district is [l more than or ff less than 10,000; and now, therefore, <br />(Chcck onc) <br />BE IT RESOLVED by the governing body of the taxing district that an increase in the regular property tarc levy <br />is hereby authorized for the levy to be collected inthe 2022 tax year. <br />(Year ofcollection) <br />The dollar amount ofthe increase over the actual lcvy amount from the previous year shall be S 9s.08 <br />which is a percentage increase of 1,0 %o from the previous year. This increase is exclusive of <br />(Percentage inclerse) <br />additional revenue resulting froln new conshuclion, improvements to property, newly constructed wind turbines, <br />solar, biomass, and geothermal facilities, and any increise in the valui ofstate'assesied property, any annexations <br />that have occurred and refunds made. <br />Adopted this 28 day of October 2021 <br />If additional signatures are necessary, please attach additional page. <br />Inlt n{n or its equivalent rnust be submitted to your county assessor prior to their calculation of the property ta.x <br />levies. A.certified bYdg"9!g"y request, separate from this form is to Ue fited with the County Legislative Autfioiity <br />no later than November 30ft. As required by RCW 84.52.020, that filing certifies the total amount to be levied by-theregularpropertytaxIevy.T'hepepartmentofRevenueprovidesthe:.Levycertinc@o61 <br />for this purpose. The form can be found at: httn://dor.wa.eov/docs/forms/ProbTx/Forms/Lewcertf.doc. <br />To ask about the availability of this publication in an altcrnate format, plcase call l-800-647-7706. Tcletypc (fiy) uscn may <br />use the washinglon Relay service by calling 7l l. For tax assistance, cau 1:eo; 534-1400. <br />REV64 0l0lc (w) (l2l9lt4\