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D epartm ent of r~ Levy Certification <br />Revenue'\..:: <br />Washington State <br />Form 640100 <br />Submit this document, or something similar, to the county legislative <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 />In accordance with RCW 84.52 .020, I !Jerica Pascoe (Name), <br />I Finance Director I (Title), for jcity of Ellensburg (Dis t rict name}, <br />do hereby certify to the !Kittitas I (Name of county) County legislative authority <br />that the lcou ncil I (Commissioners, Council, Board, etc.) of said district requests <br />that the following levy amounts be collected in 12025 I (Year of collection) as provided in the district's <br />budget, which was adopted following a public hearing held on 111118/2024 I (Date of public hearing). <br />Regular levies <br />Levy General levy Other levy* <br />Total certified levy request <br />amount, which includes the <br />amounts below. <br />Administrative refund amount <br />Non-voted bond debt amount <br />Other * <br />Excess levies <br />General <br />$3,900,000.00 <br />Levy (n/a for school Bond <br />districts) <br />Total certified levy <br />request amount, <br />which includes the <br />amounts below. <br />Administrative refund <br />amount <br />Other * <br />Enrichment <br />(school Cap. project <br />districts only) <br />Other levy* - <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 when using_ th W<lr" options . . . <br />Signaturer)<T A A,{ -lA 1 /fv C Date: II I lg \ lOZ.y ~~ \ ~ <br />To request this aocument in an alternate format, please complete the form dor.wa .gov/AccessibilityRequest <br />or call 360-705-6705. Teletype (TTY) users please dial 711. <br />REV 64 0100 (8/23/22) Pa ge 1 of 1