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NOTICE OF LYEN A~~01K~
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aw. l 9 io AM'71
STATE OF FLORIDA ~3 ~:849
COUNTY OF ST. LUCIE •
I~OTICE is hereby given that pursuant to the provisions of
Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Co:.imissioners of St. Lucie County, Florida, claims a lien in the
amount of Six Hundred Twenty-two and 27/100
622.27 ) Dollars against any real or personal property or ~
interest therein presently held or after acquired by
~ (Name of :
Marie Jordan of Rt. 1, Box 709a, Fort Pierce, Fla. }
Indigent or Recipient) (Address) ' '
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for money directly spent by St. Lucie County for the care, hospital- ~
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ization, sustenance or maintenanc~ of said Indigent or Recipient ~
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted• 4/12/72 - ~
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Date Discharged: 4/23/72 , ~
Number of Days: 11 at $ 56.57 per day= $ 622•2~
i Less credits None •
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~ Amount of Lien $ 622•2~
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DATED at Fort Pierce, Florida, this (e day of
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July , 19 ~2.
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, (S gnature)
County Attorney-
(Title)
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SWORi` to and subscribed before me -
t:,is ~ day of , 19~. _
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' \otar.~ Public State oi Florid at Larq e ~
a ppTARY MIBLIC. STATE OF FLORIDII AT U1R6E - `3
MY C01Ai~1:,S10N EXPIRES JAN. 21, 1974 ~t
:tiIS/ COmirilsSlOl'1 EXplYES • ~~DED TMRU fREO W. DIESiEIH(1RSi " j
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7HIf INSTRUMFNT WAS PREPARED BY ~ - t~
8001~ ~O~ ~ ~ :~:S~~s•;
RALPH B. WILSOV. £T. LtiCIE COUNTY
~COtJRTHOUSE. FT. PlERC~ FLORIDA • ~
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