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NOTICE OF LIEN ls~r~U~ ~
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STATE OF FLORIDA t
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COUNTY OF ST. LUCIE
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NOTICE is hereby given that pursuant to the provisions of
Chapter 65-2181, Laws of ~Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the '
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amount of One Hundred Thirty-two and 95/100
132.96 ) Dollars against any real or personal property
or interest therein presently held or after acquired by ~
(Name of
Ralph Smith of~ 2117 No. 17th St., Fort pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted• 7/14/69
- Date Discharged: 7/17/69
Number of Days: 3 at $ 44.32 per day = $ 132.96 -
E Less credits None
~ 132.96 ~
~ Amount of Lien $
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• DATED at Fort Pierce, Florida, this ~N day of
December ~ 196~.
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FILEO AND RECORDED~ .
~ ST.RECQFt~ ~ERTFIEDLA~ -
~ 1$s,,~UB (sig ature)
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~ ~ • Count Attorne `
~ '69 OEC 8 PM 2.06 Y Y
~ /1~az~~G~-~ (Title) ~
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F~p~~~ i OITRf+S
CLERK CIRCUIT COURT`.
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~ SWORN to and subscribed before me
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~ this day of c ~ , 1969. ~
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~ No y P ic State of Florida ~ Large
~ My Commission Expires: ~~i
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THIS INSTRUMENT WAS PREPARcD BY ~
RALPH B. WILSON. ST. LUCIE COUNTY O k ~
r`~ COURTHOUSE. FT. PItRCE. FLURiDA BOOK PAGE ~1.(~
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