HomeMy WebLinkAbout0761 ~ 186150 ~ ~~str~ment was pre ~ ~ ~
~ fior~~~ ~e~artment Attorne
~ pry~~ of PuDlic Weltare y
AFFIDAVYT OF LIEN ON REAL P~OP6RTY P~ ~x 2p50
~ckwnville, Fb~da `
STATE OF FLORIUA 32~'03 ;
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COUNIY OF . ~
Before me the underai ed authorit on this da ~
. 8n y, y personally appeared .
Blla L. Henderson ~
,~rho being by me first duly a~rorn, ;
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deposea and says: ~
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That s
he has this day epplied for a determination of eligibility for public ~
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aesistance from the State of Florida under the Social Welfare Act, Florida Statutes, ~
Chapter 409, and the underaigned affiant being the owner of certain non-homeetead real ;
property, which vould ma~ke the affiant ineligible for public assistance vithout this ~
affidavit creating a lien against the real property, and the affiant hereby declares ~
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the public assistance paymenta to be mnde to the affiant from thia day forw8rd ahall
create and be a lien againat the below-deacribed real property for the full amount
of said payments. This lien ehall be enforceable by forecloaure against said property
at the time of the~death of the undersigned, or upon the death of the aurvivor of them,
whichever occurs last, if executed by man and wife, or at such tiane as affiant sells ~
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or otherwiee alienates the land prior to her death. This lien shall be auperior to
all other liens which do not heretofore exist against the following described real ;
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property in St. Lucie County, Florida:
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Lot 13 and 14, Block A, Edgewood park a8 entered in Book #89, page 30;
of the Publfc Records of St. Lucie County.
Affiant further represents that in the event of sale of said property be- ~
fore the aforesaid lien is paid in fu21, ~he will notify the purchasers in such sale ~
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of the existence of the herein-described lien and that in the terms of the sale 8 he ~
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will require that the Department of Public Welfare be paid in full out of the pro~eeds ~
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of the sale at the time of the closing of the sale.
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Dated this ~ day of , A. D. 196~.
~ . G(~~ ~
Sworn to and subscr ed before me Affiant ~
this ~ day of ~ ~
A. D. 146~,. . '
FILEO AND RECORDED'
~ 1 ST, LUCIE COUNTY. FIA.
R~CORD VERIFIEO
N tary Public ~ 18~iSO ~
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i:otasy Pu~zic. Statc c` . ; i 12 '69 NOV 2 S PM 12 Z k
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~ ~ b nOGER POITRAS
. CLERK CIRCUIT COURT:
Form .~p-1~1, November 1965
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