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~ NOTICE OF ~ LIEN C~EaR c~RCt~1T OOYIIT~`
RECORO YfRii1E0.....~.~.
p~c 3 ~ ~v ~M'11
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STATE OF FLORIDA ~~~Q
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
amount of One Hundred Seventy and 43/100 -
170.43 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Robert Harrell of 522 N. llth 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:
Nospi~al: Fort Pierce Memorial
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~ Date Admitted: 5/29/71
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`s Date Discharged: 6/1/71 ;
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~ Number of Days: 3 at $ 56.81 per day= $ 170.43
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~ Less credits None
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F Amount of Lien $ 170.43
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DATED at Fort Pierce, Florida, this ~/V~ day of
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~ I?ecember 19 71 ~
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= (Slgnature) ~
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Cvunty Attorney
° (Title)
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~ SWORN to and subscribed before me
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" this a day of a~ , 197/ . 4
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- Notary Public State of Flor' a at Large - ~
~ My Commission Expires: /-d/ 77~' - ~
TH18 IN!'TRUMFPIT WAS PREPARED E~/ , : ~ -
RALPH B. WILSON. 5~. LJCiE GOUNTY
GOURTHOUSE. FT. PIEf2GE. FLOR1Gh ~r,
€~19~ ~1968