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2;2193'7 i~~ivc~'~ ° ju?~+TY Fu°?.
AMENDED ROCE~ ~~~TAAS
NOTICE OF LIEN CLERK C. •GU~T COURT
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J~u~ 11 9 3a AN'TZ
STATE OF FLORIDA
COUNTY OF ST. LUCIE 22193'~'
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 Ten Hundred Sixty-one and 76/i00
1061.76 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(1~Iame of
Isaac Johnson of 812 N. 17th 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: Jackson Memorial Hospital
~
E Date Admitted: 6/26/71
€ Date Discharged: ~/28/~l
r
~ Number of Days:12 Pd- at $ 88.48 per day= $ 1061.76
~
- Less credits None
~ 1061.76
~ Amount of Lien $
~
~
x DATED at Fort Pierce, Florida, this day of
~ (This Amended Notice of Lien supersedes
~ January , 1972 . Notice of Lien dated December 3, 1971
~
and recorded in OR Book 197, Page 1977.)
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~ '
ignature)
County Attorney
~ (Title)
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SWORN to and subscribed before me
,
,
this 1L~ day o€ , 197~ , ~ ~ ~
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_ , , ~ . _ . ,
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Notary Public State Florid at Large
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My Commission Expires 02~- ~ ~ .t •`..f-
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TFlfa 1NSf.•tU~~~'-~ • •r i ~'°"'"?'D AV
- RALPH B Y~; . . ' . . . : _ ~ lf
GOURTHOUSE, F_i. r~u.~:.::, t~GRi~A
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