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Department ofRevenue Levy Certification NOV 2 2WashingtonState <br />Submit this document to the county legislative authority on or before November 30 of the year precedingtheyearinwhichthelevyamountsaretobecollectedandforwardacopytotheassessor. <br />In accordance with RCW 84.52.020,I,Elizabeth Allgood , <br />(Name) <br />Treasurer ,for Kittitas County Public Hospital ,do hereby certify toDistrictNo.1 <br />(Title)(District Name) <br />the Kittitas County legislative authority that the Board of Commissioners <br />(Name of County)(Commissioners,Council,Board,etc.) <br />of said district requests that the following levy amounts be collected in 2018 as provided in the district's <br />(Year of Collection) <br />budget,which was adopted following a public hearing held on 10/26/17 <br />(Date of Public Hearing) <br />Regular Levy:$25,000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy:$1.426,137.50 <br />(State the total dollar amount to be levied) <br />Refund Levy:$0.00 <br />(State the total dollar amount to be levied) <br />To ask about the availability of this publication in an alternate format for the visually impaired,please call (360)705-6715. <br />Teletype (TTY)users,please call (360)705-6718.For tax assistance,call (360)534-1400. <br />REV 64 0100e (w)(2/21/12)