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Re'"fffit@ <br />Woshington Stote <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 />nt an alternate format, please complete the form dor.wa.gov/Accessibi lityRequest <br />or 360-705-6705. Teletype (TTY) users please dial 71 1. <br />Form 64 0100 <br />tn accordance with RCW 94.52.926, I tAy MCGOWAN fiame), <br />MAYOR ffitte),1o1 ctry oF ctE ELUM @istrict nome), <br />do hereby certify to the KlTTlrAs flome of county) County legislative authority <br />that the cLE EtuM clrYcouNcll @ommissioners, Council, Boord, etc.) of said district requests <br />that the following levy amounts be collecte.6 in 2o24 (Yeor of coltection) as provided in the district's <br />budget, which was adopted following a public hearing held on tol23l2o23 @ate 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 other amounts include levy error correction or adjudicated refund amount. Please include <br />a description ng r" options. <br />C <br />Datel o-zb-23 <br />To uestreq <br />call <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />$ gao,om.oo <br />Administrative refund amount <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 />L-J <br />Administrative refund <br />amount <br />Other* <br />General <br />(n/a for school <br />d i st ri cts) <br />Enrich ment <br />(school <br />districts only) <br />Other I <br />Levy Bond Cap. project <br />REV 64 OL00 (8/27/2r)Page 1 of 1