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NOTICE OF LIEN Rf~3 ~f-•~i~D
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.~r 1~ J~ 19 ~N '11
STATE OF FLORIDA 2.~~~5
COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant to the pravisions of
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Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, ciaims a lien in the
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amount of ~o Hundred Eighty-four and 05/100 ~
264.05 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Estelle Johnson of 2707 Booker St., Ft. Pierce, Florida
Zndigent or Recipient) (Addressj
for money directly spent by St, Lucie County for the care, hospital-
izatioa, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
i Date Admitted: 8/18/71
` Date Discharged; 8~23/71
` Number of Days: at $ 56-81 per day= $ 284.05 ~
1
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Less credits None ~
Amount of Lien $ 284.05
DATED at Fort Pierce, Florida, this ~ day of
January 19 ~2.
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' ( ignature)
County Attorney
(Title)
SwORN to and subscribed before me
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this ~day of ~ _ , 19~. ~
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Notary Public State of Florid t Large ;
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My Commission Expires: / Z~ ~
THIS IN~RLM~r~T yyAS PR^aAncp EY ,
COURTH01J6E. UFT. PfERCC,~FLCR A ovM~~~ P~CE~~~
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