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NOTICE OF LIEN ~tE~GRl YCR1F:Fp~~
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STATE OF FLORIDA
222028
COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant ta 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 Four Hundred Fifty-four and 48/100
454.48 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Sam Donaldson of 1608 Avenue M, 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: 6/8/71
Date Discharged: 6/16/71
Number of Days: a at $ 56.81 per day= $ 454.48~
Less credits None
Amount of Lien $ 454.48
DATED at Fort Pierce, Florida, this /.2 day of
January , 1g72 . , ~
.
• . ( gnature) ~
;
County Attorney ;
(Title)
SWORN to and subscribed before me
~ ~
this day of ~~4.~ , 197.~ . i
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3
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Notary Public State of Flori a at ~arge
My Commission Expires : /-vt/- ~j~ •
~IS INSTRUMENT WAS PRPP~.
RALPH B. WILSON. ST ~UC!~ CC~eY~Y
CO!/R7HOUSE, FT, p~ERGE, FLORIDA ~1 i
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