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Department of <br />Revenue <br />Woshrngton Stote <br />Form 54 0100 <br />ln accordance with RCW 84.52.020, I <br />Chief <br />a descripti <br />Signature: <br />on when <br />To req <br />or call <br />Sinclair <br />(Title), for Counw Fire Protection Dlstrict 2 (District name), <br />@ <br />KD5oluh on Lq' L1" <br />Levy Certification <br />Submitthisdocument,orsomethingsimilar,tothecountylegislative <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 />(Nome), <br />do hereby certifY to the (Name of county) County legislative authority <br />that the (Commissioners, Council, Boord, etc') ol said district requests <br />that the following levy amounts be collected in (Year of collection/ as provided in the district's <br />budget, which was adopted following a public hearing held on Lt 11.412024 (Dote of public hearing) <br />ar levies <br />Excess levies <br />Examples of other levy tYPes maY I nclude EMS, school district transportation, or constru ction levies. <br />Exampl es of other amoun include levy error correction or adjudicated refund amount. Pl ea se include <br />options.1 <br />1 //-//''7/ <br />document in an alternate format, please complete the form d%iyA,gSu/Aesesiblij$&eggeg <br />705-6705. TeletY <br />Flre District 2 <br />of Fire Commissloners <br />9,500,000.00Total certified levY request <br />amount, which includes the <br />amounts below. <br />79.!LAdministrative refund amount <br />Non-voted bond debt amount <br />Other* <br />Other levY*General levYLevy <br />L-J <br />490,000.00Totalcertified levY <br />request amount, <br />which includes the <br />amounts below. <br />59.76Administrative refund <br />amount <br />Other* <br />General <br />(n/a for school <br />districts) <br />Enrichment <br />(school <br />districts onlY) <br />Other I <br />Cap. project <br />* <br />BondLevy <br />REV 64 Oloo 18/231221 <br />pe (TTY) users please dial 71 1. <br />Page 1 of 1