HomeMy WebLinkAboutFire District 4Department of
Revenue
Washington State
Levy Certification
DEC 2 2 , `lk?
Submit this document to the county legislative authority on or before November 30 of the year preceding
the year in which the levy amounts are to be collected and forward a copy to the assessor.
In accordance with RCW 84.52.020, I, Chris Cudip _
(Name)
Secretary for Kittitas Cvurlty Fire Dist #4 , do hereby certify to
(Title) (District Name)
the Kittitas
(Name of County)
County legislative authority that the Cllitlimss)(MaI:s
(Commissioners, Council, Board, etc.)
of said district requests that the following levy amounts be collected in 2018 as provided in the district's
(Year of Collection)
budget, which was adopted following a public hearing held on 12/11/17
(Date of Public Hearing)
Regular Levy: $28,000.00
(State the total dollar amount to be levied)
Excess Levy:
(State the total dollar amount to be levied)
Refund Levy:
(State the total dollar amount to be levied)
Signature: _ Date:
is -1611(
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REV 64 0100e (w) (2/21/12)