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~ILEO ~.r0 REC~ROEO ~
• ST.IUG~E COUNTY flA.
' ROCER POITRAS ~
CLERK CIRCUIT COURT
~ NOTICE OF LIEN RECORD VERIf1E~~~~
D~c 3 8 sv ~M'TI
cTATE OF FLORIDA
COUNTY OF ST. LUCIE
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, Floricia, claims a lien in the
amount of Fi~teen Hundred Ninety and 6g/100
1590.68 ) Dollars against any real or personal property or
interest therein presently held or after acquirea by
(Name of
Patricia Lacey of 1212 N. 17th St., Fort Pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
zzation, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows;
Hospital: Fort Pierce Memorial
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Date Admitted- 5/6/?1
€ Date Discharged: 6/3/71
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' Number of Days: 28 at $ 56.81 per day= $ 1590.68
3
j Less credits None
~ Amount of Lien $ 1590.68
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DATED at Fort Piexce, Florida, this ,Z JYO day of
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~ December ~ 1g71 .
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(Si nature)
County Attorney
(Title)
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SWORN to and subscribed before me _
= this ~ jt,G~. da of ~ .Q/~ , 19 7~. ^
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Notary Public State of Flori at Large ~~!'y
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i~ly Commission Expires ; - 7 ~ ' .:y~. .
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- THIS INSTRUMPrt~r LyAC PPEPARED BY ,
- RALPH B. WIL5G?~. ST L~_ C(~ ::^U!~TY
GOURTHOUSE. FT. PIcRGE. FLOR~DA Q~197 P`AP~~~~
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