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Y
/IlEO ANO RECOROEO
ST.lUC1E C~UMTr F~A. ~
ROCE~ aO~TR~S
CIERK C~rZ4UiT COURT t!`
• NOTICE OF LIk:Ni RECQRL vF;~~~~p~~ ~
~ 13 10 i9 AN'11
STATE OF FLORIDA 2~' 20~ A
.f
C~JNTY OF ST. LUCIE ;
I~OTICE is hereby given that pursuant to the provisions of
Chapt~r b5-2181, Laws of Florida, Acts of 1965, the Board of County
Com-nissioners of St. Lucie County, Florida, claims a lien in the
amount of Sixteen Hundred Forty-seven and 49/100
~
1647.49 ) Do11ar`~s against any real or persona~ pzoperty or
~
interest therein pres~~tly held or after acquired by
Cha man Green (Name of
P of 128 N. 13th St., Ft. Pie rce, Florida
Indigent or Recipient) (Address)
for money directly spent by S~.. Lucie County for the care, hospital-
;
i
ization, sustenance or maintenance of said Indigent or Recipient !
~
of welfare assistance, as follows:
Hospital; Fort Pierce Memoria2
Date Admitted: 8/31/71
~ Date Discharged: 9/24/71
~
Number of Days: 29 at $ 56•82 per day= $ 1647.49
Less credits None
Amount of Lien $ 1647.49
DATED at Fort Pierce, Florida, this day of
January ,.19 ~2. .
. ~
.
(S gnature)
County Attorney
(Title)
SWOR.~i to and subscribed before me
: ~ ~ rl
tnis /„~l
day of .L - , 19Z.
, ~
;~,r ~ ~ ;
Notary Public State of Flori at Large ~
My Commission Expires: / ~
"r
TH~a 1NSTRUMFn;+ {,y~5 PRFPRpED BY
RALPH B. WtLSJ"i. ST L,~~~;~ C~'.VTy s 1g8 ~E~~~
GOURTHOU6E, YlEF2CE, FLORiDq DQOK
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