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(Name), <br />Chairman of the Board (Title), for Snoqualmie Pass Fire & Resscue (District name), <br />do hereby certify to the King and Kittitas (Name of county) County legislative authority <br />that the Fire Commissioners (Commissioners, Council, Board, etc.) of said district requests <br />that the following levy amounts be collected in 2024 (year of collection) as provided in the district's <br />budget, which was adopted following a public hearing held on 11/08/2023 (Date of public hearing). <br />lar levies <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 />$1,200,000.00 <br />$87,118 <br />Total certified levy <br />FD 51: <br />request amount, <br />$64,044.00 <br />which includes the <br />FD8: <br />amounts below. <br />$41,336.50 <br />Administrative refund <br />amount <br />Other* <br />*ExamD <br />Department of <br />Revenuee (- <br />Washington State <br />Form 64 0100 <br />Levy Certification <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, 1 William Powers <br />types may include EMS, school district transportation, or construction <br />Examples of other amounts may include levy error correction or adjudicated refund amount. Please include <br />a description when using the "otl er" options. <br />Signature: //��_ rDate: — <br />To request this document in an alternate format, please complete the form dor.wa.gov/AccessibilityRequuest <br />or call 360-705-6705. Teletype (TTY) users please dial 711. <br />REV 64 0100 (8/27/21) Page 1 of 1 <br />