HomeMy WebLinkAbout0062 • . . ~ 1921~
,
AFFIbiAVIS OF LIEiI Oll ~BAL PROPBI~'PY This Instrument w~s prepa~ed by; -
S SfROME MAX1MEtl. pep~rtment AtEomey
S?A?E OF lIARIDiA ~ Florida yyelhn
oov~rrY or ~ _ ~0fN1~ Flo~~ 32203 .
Before ~e, tha undsr~ignsd authorit~, oa thia day peraoAall~ ~ppearad
;
Paul P. Pullen , Mho beiug by oe first duly avorn ;
deposea and says:
Th~t he has this da~ appli~d fos a datarainatioA of eligibility for public
assistance fros the State of Florid~ under Chaptar 409 of the Florid~ Statutes, ~iad
the naderaigned affiant being the o~msr of certain non-hoaestead real property, vhich
~wuld oake the affiant inaligible for public assistance ~rithout thia affidavit creatiag
a lier againat the real'property, and the affiant heseby declares the public assiatanca
pay~nta made to and on behalf.of the sffiant frca the date statcd below ahall create
and be a if~a against the belo~r-deacribed real property for the full amount of said
payments. This lien shall be enforceable by foreclosure against said praperty at the
time of the death of the undersigned, or upon the deatb o£ ths survivor of them, Nhich-
ever occurs laat, if executed by man and ~rifa, or at such time as affiant sells or
otherviae :iienates the land prior to his death. Thia lien shall be superior to all
other liens ~rhich do not heretofore exist againat the follaving described real property ~
in St. Lucie County, Florida: (Include legal deacription 6 secording dats)
1
Lot 8, less N 5 ft, 1~,icker Terrace, Block 2, as recorded in Deed Book #193, p•l9 f
i
?
Affiant further reprasents that in the event of sale of said propesty before
the sforesaid lien ia paid in full, he Mill notiff the purchasers in such sale of the
ezisteace of the herein-deacribed lien and that in the t=roa of the sile he ~rill re-
qufse th:t the Depsrtaent of Health and Behabilitative Sesvices, Division of Fa~il~
Services, be paid in full out of the proceeds of the sale at t6e tiae of the cZcsing
~
of the sale. ;
Dated this ~ day of , A. D. 19~, aad F
Bffective the lst day of ~ ig
v
S~orn to and subscri d befora ~e ;
this aay of ~ t
S7'. E 1 O~
A. D. 19 . . ~£"tSRC1 ~!~[~fF1E~A. i
. 1921~5
. . ; ~ '70 APR I 5 AM I~ ; ys o.~'~'
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ta~ Public -•:~~~i1.'.:;.,"': ~;',i, - - '
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':etarr a.:WK. St~te o~ ~Ixid~ at l+rqe :=~o d c? . CLERK ~1RCU~~' .EOUR~" ~
~hy CoG1..~s:i.wa :.r.;.~ras 1972 - - : ~ i
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~ '•r.~i~:~'.~ BDOJ(~D~ PAGE iN~ `
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FOiCPi YA-11, Septe~ber 1969 '•.:~+,~t~:"`~`