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ECORO VERIFIEp
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STATS OF FLORIQA tiO,E~ ~•~ITRA$
CL~~iK CIRCUIT COURT
covrrrx o~ sT Lt~c=s ~
i~OT=CB is hereby gfven that purauant to the pr~visiousa ot
Chapter 65-2181, Lawe of Florids, Acts o! 196S, the eoard of County
Commiseionera o! St. Lucie County. Blori~a, . alaiuas a lien in t2se
.
amaunt o! Five Hundred Tw~elve and 40/100
512.40 )~llars againet any real or personal proparty or
interest therein preeently he18 or after acquirea by
James ~eaver o~ 426 No. 8th at., ForttPi~erce,f Florida
indigent or recipient) (Addrees)
for money directly spent by St. Lucie County for the care, hospital-
i2ation, suste~sance or maintenance of eaid incligent or recipfent
of velfare assistance, ae follo~we:
Aospital: Shande Teachinq Hospital, Gainesville, Fla.
Date Acbnitted: 4/9/67
~ Date 8ischargeds 4/22/67
DTwN~er of Daye: 12 at $ 42.70 per d8y s$ 512.40
Lese creclite Wone
Amount of I,ien ~ 512.40
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- DAT~ at Fort Pierce, Florida, thie day of _Julv,,,
19_67 .
' ~
- (Si ature) ~
County Attorney ~
(Title) . • - ' ~
S~ORM to aad eubscribad before ms ~
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thi• -day o! . 19~ . - : - ~ ~
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~.~ioLarX. Publif $t4ts of l~lori t Lasge
-i~r ~Commise~c~ mcptres: ~D / (o
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