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Re{,dfflit@ <br />RffiGffiHV[;'ffi <br />Levy Certification <br />Submit this document, or something similar, to the county legislative <br />authority on or before November 30 of the year pre^cedfihF-t863,ffi1#WhEn-- <br />the levy amounts are to be collected. EOARD o <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 />Woshington State <br />Form 54 0100 <br />ln accordance with RCW 84.52.020, I <br />Seoetary-Financial Mgr.(Title), f or <br />do hereby certify to the <br />Board of Fire Commissioners <br />To req <br />or call <br />is document in an alternate format, <br />360-705. Tgletype (TTY) users please <br />Jeannine Livande (Name) <br />(District name), <br />(Name of county)County legislative authority <br />(Commissioners, Council, Board, etc.) of said district requests <br />please com p lete the form dor.wa.gov/Accessi bi I ityReq uest <br />dial 71 1. <br />Page 1 of 1 <br />Kittitas Co. Fire Protection District 6 <br />that the <br />2025that 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 Lut2l2024 (Date of public hearing) <br />ular levies <br />Excess levies <br />*Examples of other levy types may include EMS, school district transportation, or construction levies <br />Examples of other amounts may include levy error correction or adjudicated refund amount. Please include <br />a description hen using the "o er" options <br />Signature:Date: I I la <br />1,000,000.00Total certified levy request <br />amount, which includes the <br />amounts below. <br />t,487.02Admi nistrative refund a mount <br />0.00Non-voted bond debt amount <br />0.00Otherx <br />General levy Other levy*Ievy <br />L-.J <br />Total certified levy <br />request amount, <br />which includes the <br />amounts below. <br />0.00 <br />0.00Administrative refund <br />amount <br />0.00Other* <br />General <br />(n/a for school <br />districts) <br />Enrichment <br />(school <br />districts only) <br />Other I <br />Cap. projectBondLevy <br />REV 64 OLOO (8/23/22\