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~ ~,7V ~ 5 NOTICE OF LIEN p~C1t1~ C~RCUtT COURt
Il[d0110 VCIt~P~EO
~ ~ 8 ~S ~'Z ~
STATE OF FLORIDA ~'i"~~`~
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 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
Carol Rober::~ of 1821 Fulton Dr., Fort Pierce, rlorida
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
i
~ 6/12/71
Date Admitted:
s
~
~ Date Discharged: 6/15/71
t
~ Number of Days: 3 at $ 56.g1 per day= $ 170.43
- ~ Less credits None
~
~ Amount of Lien $ 170.43
f~ _
~
~ DATED at Fort Pierce, Florida, this day of ~
~ December , 19~~
-
.
~
;x .
(Signature)
,Y;
County Attorney
(Title)
SwORN to and subscribed before me
this o?ix,~ day of ~ , 19 7/ .
~
~d ~ ~
= Notary Public State of Flor' a at Large _
% My Commission Expires : ~7~ _ . '
THIS IN6?RU~!~.•.~ •.:A~ P'^~:•.°~~ FY • .
RALPH B. W1~5^N. S` ~I~ _~~.til'Y B~~~
GOUFTHOUSE. F7. F'~LKGF.:. FLORiDA
,
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