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Department ofRevenue Levy Certification <br />Washington State <br />Submit this document to the county legislative authority on or before November 30 of the year preceding <br />the year in which the levy amounts are to be collected and forward a copy to the assessor. <br />In accordance with RCW 84.52.020,I,William J.Powers Jr. <br />(Name) <br />Chairman,Board of Fire Commissioners ,for Snoqualmie Pass Fire &Rescue ,do hereby certify to <br />(Title)(District Name) <br />the Kittitas County legislative authority that the Board of Fire 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 11/30/17 : <br />(Date of Public Hearing) <br />Regular Levy:$310,000.00 <br />(State the total dollar amount to be levied) <br />Excess Levy:$69060 <br />(State the total dollar amount to be levied) <br />Refund Levy:$0.00 <br />(State the total dollar amount to be levied) <br />Signature:Date: <br />To ask about the availability of this publication in an alternate format for the visually impaired,please call (360)705- <br />6715.Teletype (TTY)users,please call (360)705-6718.For tax assistance,call (360)534-1400. <br />REV 64 Ol00e (w)(2/21/12)