Laserfiche WebLink
Reflefitit@ Levy Certification <br />Submit this document, or somethlng slmilar, to the county leglslatlve <br />authority on or before l{oyamber 30 of the year preceding the year ln which <br />the levy amounts are to be collected. <br />Courtesy copy may be provlded to the county assessot: <br />This form is not designed for the certification of levies under RCW 84.52.070. <br />Woshington Stote <br />Form 64 0100 <br />ln accordance with RCW 84.52.020, I <br />(Title),lor <br />do hereby certify to the <br />that the <br />that the following levy amounts be collected in <br />Excess levies <br />Exa <br />To document in an alternateformat <br />lames L DeVere (Name), <br />as provided ln the district's <br />(Date of publlc heortng]. <br />the form dor.wa.govlAccessiblllVRequest <br />tfte Torn of Souttr Ch Elum (Dlstrlct name), <br />(Name af county) County leglslative authority <br />(Commissioners, Council, Board, etc.] of said dlstrict requests <br />20z5 <br />please <br />dlal71 <br />(Yesr of <br />budget, which was adopted following a public hearing held on <br />levies <br />other evy types may include EMS,transportatlon, or construction <br />Examples amounts may lnclude levy error correction or adjudlcated refund amount. Please lnclude <br />a options. <br />Slgnatu Date z l, <br />or <br />req <br />call <br />Mayor <br />Klttltas <br />Twn Coumll <br />tut9l2or9/ <br />Total certtfied leuy reguest <br />amount, which includes the <br />amounts below. <br />136,000.00 <br />Admlnlstrative refund amount <br />Non-voted bond debt amount <br />Other$ <br />I evy Gcnr:ral levy Other lr:vy' <br />Iiotal cerdfied levy <br />request amount, <br />which includes the <br />amounts below. <br />Adminlstrative refund <br />amount <br />Otherr <br />6r: n cra I <br />{ r'j, l r,rr ..r:tt,rl f <br />:i ',1 r. ", t <br />Fnrichment <br />i,,; f-;;,1i <br />L; 'trlri: lr"|\'r ffiLevytsondCap. proir'rt <br />REv64 0LOO (8123122l' <br />Teletype (TTY) users please 1. <br />Page 1 of 1