HomeMy WebLinkAboutHospital District No. 2-EMSDepartment ofRevenue Levy Certification NOV 2 2
Washington State
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,Elizabeth Allgood
(Name)
Treasurer ,for Kittitas County Public Hospital ,do hereby certify toDistrictNo.2/EMS Levy
(Title)(District Name)
the Kittitas County legislative authority that the Board of Commissioners
(Name of County)(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 11/13/2017 :
(Date of Public Hearing)
Regular Levy:$1,250,000.00
(State the total dollar amount to be levied)
Excess Levy:$0.00
(State the total dollar amount to be levied)
Refund Levy;$0.00
(State the total dollar amount to be levied)
Signature:Date:
To ask about the availability of this publication in an alternate format for the visually impaired,please call (360)705-6715.
Teletype (TTY)users,please call (360)705-6718.For tax assistance,call (360)534-1400.
REV 64 0100e (w)(2/21/12)
Department ofRevenue Ordinance /Resolution No.l1-13-17-02WashingtonStateRCW84.55.120
WHEREAS,the Board of Commissioners of Kittitas County Public has met and considered
Hospital District No.2/EMS
(Governing body of the taxing district)(Name of the taxing district)
its budget for the calendar year 2018 ;and,
WHEREAS,the districts actual levy amount from the previous year was $619,066.18 ;and,
(Previous year's levy amount)
WHEREAS,the population of this district is more than or less than 10,000;and now,therefore,
(Check one)
BE IT RESOLVED by the governing body of the taxing district that an increase in the regular property tax levy
is hereby authorized for the levy to be collected in the 2018 tax year.
(Year of collection)
The dollar amount of the increase over the actual levy amount from the previous year shall be $6,190.66
which is a percentage increase of 1.0 %from the previous year.This increase is exclusive of
(Percentage increase)
additional revenueresulting from new construction,improvementsto property,newly constructed wind turbines,
solar,biomass,and geothermal facilities,and any increase in the value of state assessed property,any annexations
that have occurred and refunds made.
A ted thi 13 day of November ,201
If additional signatures are necessary,please attach additional page.
This form or its equivalent must be submitted to your county assessor prior to their calculation of the property tax
levies.A certified budget/levy request,separate from this form is to be filed with the County Legislative Authority
no later than November 30"'.As required by RCW 84.52.020,that filing certifies the total amount to be levied by
the regular property tax levy.The Department of Revenueprovides the "Levy Certification"form (REV 64 0100)
for this purpose.The form can be found at:http://dor.wa.gov/does/forms/PropTx/Forms/LevvCertf.doc.
To ask about the availability of this publication in an alternate format,please call 1-800-647-7706.Teletype (TTY)users may
use the Washington Relay Service by calling 711.For tax assistance,call (360)534-1400.
REV 64 0101e (w)(12/9/14)