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STl1T8 OF !'LORID~I ,
CO~Y OF 8T Y+UCIE
I~OT~CB f• h~reby given that pwc~uaut ta tho providion~ o!
C'hapter 65-2181, La~ra o! Florida, Acts of 1965, the Board o! County
Coaeniasioa~ra o~ St. Luci• County, plorida, claims a lien i~a tbs
umount of One Hundred Ninety-four and 70/100
!S._~94•~~ ) Dollar4 aq~?inst any raal or peraonal property or
interest therein preaently held or after aoquirad by
Annie Mae $vans p~ 429 Douqlas Ct., Ft. PiTer
e~ Florida
inc7lqent or recfpient) (A~ddrees)
for naney directly epent by St. Lucie County for the care, lwspital-
ization, sustenarsee or maintanance of said in8iqent or recipient
ot ~r~elfare assiatance, as follaw~ s
Hospital: Fort Pierce Memorial
Date Acip~f tted s 8123/67
,
Date dischar~ec~: 8/29/67
~1um'ber of Dayss 6 at $ 32.45 p~r day 194.70
Leas credits none
I94.70 j
Amount of Lien $ ~
- D~ATBa at Fort Pierce ~ Florida, thie day of December ~ ~
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So1~R~1 to and subacribad bsfose ~s ~ ~~':',r _ .
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this • day of 19( 7,
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