Laserfiche WebLink
Ratrffilt@ <br />Woshington State <br />Form 64 0100 <br />NOV 24 <br />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 />ln accordance with"RCW 84.52.020,; Jerica Pascoe (Name), <br />Finance Director ffitte),;or city of Ellensburc (District nome), <br />do hereby certify to the Kittitascounty (Name of county)County legislative authority <br />that the council (Commissioners, Council, Board, etc.) of said district requests <br />that the following levy amounts be collec1"6 1n 2022 (Year of collection) as provided in the district's <br />budget, which was adopted following a public hearing held on lVotl2ozl (Date of public heoring). <br />ular levies <br />Excess levies <br />*Examples of other levy types may include EMS, school district transportation, or construction levies. <br />Examples of other amounts may include levy error correction or adjudicated refund amount. Please include <br />a descripti en ust ng the her" options <br />Signatu Date: t I ZO <br />To re uest thi s dor.wa.g ov/Accessi bilityRequest <br />or ca <br />q <br />il 360-7A5-6705. Teletype (TTY) users please <br />document in an alternate format,please complete the form <br />|IITM <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />$ a,eoo,ooo.oo <br />Administrative refund amount <br />Non-voted bond debt amount <br />Other* <br />Total certified levy <br />request amount, <br />which includes the <br />amounts below. <br />$ l7s,ooo.oo <br />Administrative refund <br />amount <br />Other* <br />General <br />(n/a for school <br />d istricts) <br />Enrichment <br />(school <br />districts only)ffBondCap. projectLevy <br />REV G4 aLoo (8/27/z]l <br />dial711. <br />Page 1 of 1