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2~~ryQ . FILED 4ND ~ECJROEO
ST. ~.UCiE c~uMTr f~A. ~
ROCE' ?"UiiRAS
CIEFR C. 'CtlIT COURT
NOTICE OF LIEN RECO~[~ f=o~_
,~a !3 !0 i9 AN'7t
STATE OF FLORIDA
COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant to the provisions of ~
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Chapter 65-2181, Laws of Florida, Acts of I965, the Board of County 3
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\ Commissioners of St. Lucie County, Florida, claims a lien in the ~
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amount of Fifteen Hundred Thirty-three and 87/100
1533.87 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Chapman Green of 126 N. 13th St., Ft. Pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the car~, hospital-
ization, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows:
s
Hospital: Fort Pierce Memorial
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Date Admitted: 10/26/71
Date Discharged: 11/22/71
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€ Number of Days: 27 at $ 56.81 per day= $ 1533.87
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; Less credits None
= Amount of Lien $ 1533.87
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~ DATED at Fort Pierce, Florida, this /~2 ~ day of ;
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~ Januarv , 19 72.
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( ignature)
~ County Attorney
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SWORN to and subscribed before me
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this ~ day of lc~r.~ , 19~.
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Notar Public State o Flori at Large ~
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My Commission Expires / _ j ~ , ~ ~
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THIS INBTRUMF~:'~ Y//.5 FR~~P~s?*'p eY ~
RALPH B. WILSO?J. ST. t_~.~;c. C^.~_~~;Ty U R 1 ~
_ COURTHOUSE, FT, p1EfiCE, FLORlUA E~~~+~
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