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Attest to: <br />If additional signatures are necessary, please attach additional page. <br />ommissioner <br />Commissioner <br />This form or its equivalent must be submitted to your county assessor prior to their calculation of the property tax <br />levies. A certified budget/levy request, separate from this form is to be filed with the County Legislative Authority <br />no later than November 30". As required by RCW 84.52.020. that Fling certifies the total amount to be levied by <br />the regular property tax levy. The Department of Revenue provides the "Levy Certification" forth (REV 64 0100) <br />for this purpose. The form can be found at: http://dor.wa.gov/doesiforms/PropTx/Forms/LevyCertf doc <br />To ask about the availability of this publication in an alternate format, please call (360)705-675. Teletype (TTY) users may use <br />the Washington Relay Service by calling 711. For tax assistance, call (360) 534-1400. <br />REV 64 0101e (w) (12/9/14) <br />