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~ NOTICE OF LIEN ~~EaK ~~~CUp C~t ~
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STATE 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, Florida, claims a lien in the ~
amount of Eleven Hundred Thirty-six and 20/100
1136.20 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Emma Jackson pf 422 N. 24th 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: 2/11/71
~
; Date Discharged: 3/3/71
1
~ Number of Days: 20 at $ 56.81 per day= $ 1136.20 ~
`s a
Less credits None t
f Amount of Lien $ 1136.20
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~ DATED at Fort Pierce, Florida, this ~/VO day of •
~ December , 19 71.
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r' (Signature)
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County Attorney f
~ ,
~ (Title) '
s
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SWORN to and subscribed before me
- ~ ~
~i this day of , 19~. -~••;~~~~x~a.: ;
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Notary Public Stat of Flo ' da at Large ~r,~; '
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My Commission Expires: 7~ . ~ ~
T1/IS INSTP.UlNFNT Y.'~LS PTt°_OkP,EO BY
RALPH 6. K'1L50!1 ST LVC~E CO'JNTY ~
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