Laserfiche WebLink
Ra'#Hil[(? <br />W.Jshington Stllle <br />Form 64 0100 <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 utrder RCW 84.52.070. <br />ln accordance with RCW 84.52.020, I 1V.A.1u*,.u4-. lawcw-rJ{-^ fiome), SIU+ttr^n,-l <br />(ritte),tor Ktl-,t"1 U:,F,*li"kotttt ) (District nomal, <br />do hereby certify to the [,thh*: >3ffr;'#rtrtunty)countylegislative authority <br />. t I '.thatthe l,$fi,l.,t c$L[Vruruue(tt\v11J (Commissioners,Council,Board,etc.) ofsaiddistrictrequests <br />thatthefollowinglevyamountsbecollectedin JuJ{ (Yearofcollection) asprovidedinthedistrict's <br />budget, which was adopted following a public hearing held on ll/14 ld 3 @ate of public hearing). <br />lar levies <br />Excess levies <br />Examp es evy types mav in EMS, school rict transportation, or construction evtes <br />Examples of other amounts may include levy error correction or adjudicated refund amount. Please include <br />a description using the options. <br />Date: ttfij/e3Signature: <br />To document in an alternate format, please complete the form dor.wa.gov/AccessibilityRequest <br />-6705,Teletype (TTY) users please dial711.or cal <br />lrL <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />{t1o,uoo'aD <br />Admi nistrative refund amount l , l-t 1.51 <br />Non-voted bond debt amount {i9* <br />Other*-,4) <br />General levy Other levy*Levy <br />Total certified levy <br />request amount, <br />which includes the <br />amounts below. <br />ri <br />Administrative refund <br />amount tJ <br />Other*'u <br />General <br />(n/a fur school <br />rlrstricts) <br />Enrichment <br />(schoc.ri <br />districts only)ffiBondCap. projectLevy <br />REV 64 0l-00 (8127/z7l Page 1 o{ I