HomeMy WebLinkAboutSouth Cle Elum Levy CertificationDepartment of
Revenue c
Washington State
Form 64 0100
Levy Certification
Submit this document, or something similar, 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.
Courtesy copy may be provided to the county assessor.
This form is not designed for the certification of levies under RCW 84.52.070.
In accordance with RCW 84.52.020, I liarnes L. DeVere (Name),
Mayor (Title), for the Town of South Cie Eium
((District name),
do hereby certify to the Kittitas (Name of county) County legislative authority
that the Town Council (Commissioners, Council, Board, etc.) of said district requests
that the following levy amounts be collected in 2024 (Year of collection) as provided in the district's
budget, which was adopted following a public hearing held on 11/21/2023 (pate of public hearing).
lair levies
Total certified levy request I
136,000.00
amount, which includes the
amounts below.
Administrative refund amount
Non -voted bond debt amount
Other*
Excess levies
LAG1J+J.r+CZ0 vi UUMI MVY Lypes may Incluae tMS, scnooi aistrict transportation, or construction levies.
Examples of her amounts may include levy error correction or adjudicated refund amount. Please include
a descriptionf hen usin "otDer"le
Signature•Date: t A r
To request s ocument in an alternate format, please complete the form dor.wa.gov/AccessibilitRequest
or call 360- 5-6705. Teletype (TTY) users please dial 711.
REV 64 0100 (8/23/22) Page 1 of 1