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R3v[ffli:;@ <br />Wilshrngao/t St.(,te <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 under RCW 84.52.070. <br />ln accordance with RCW 84.52.020, I (Name),Brent Hals <br />Mayor of <br />Kiftitas <br />(District name),(Title), f or <br />do hereby ce to the (Name of county) County legislative authority <br />that the (Commissioners,Cauncil, Board, etc.) of said district re q ue sts <br />that the following levy amounts be collected in 2A24 (Year of co as provided in the district's <br />(Date of public hearing).budget, which was adopted following a public hearing held on <br />Regular levies <br />Excess levies <br />*Examples of other levytypes may include EMS, school district transportationf or construction levies. <br />Examples of other amounts may include levy error correction or adjudicated refund amount. Please include <br />a description when using the "other" options. <br />Council <br />'t1t't4t2023 <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />$246,3U.24 <br />Administrative refund amount <br />Non-voted bond debt amount <br />Other* <br />General levy Other levy*Levy <br />Total certified levy <br />request amount, <br />which includes the <br />amounts below. <br />$30,2 11 <br />Administrative refund <br />amount <br />Other* <br />Ge ne ral <br />(nl a for school <br />d istricts) <br />Enrichment <br />( school <br />districts only) <br />Other levy* <br />Bond Cap. projectLevy <br />Signature: <br />.tt/ rdt<]Oate: tU28l2O23