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.T ~IIOIE COItNTYA~~ .
CIERK 0 RC~~?'It CO~tIRT ,
' NOTICE OF LIEN ' RECORD YERIFIEO '
~ ~MI. l 9 10 ~1'~Z
~ STATE OF FLORIDA ~~~~GV~
COUNTY OF S~ LUCIE - ~
NOTICE is hereby given that pursuant to 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 Three Hundred Ninety=five and 99/100
395.99 ) Dollars against any r~al or personal property or
interest therein presently held or after acquired by
(Name of
Willie Mack of 2002 Avenue D, Fort Pierce, Florida
Indigent or Recipient) (Address)
for money-directly spent by St. Lucie County for the care,~hospital-r ~
ization, sustenance or maintenance of said Indigent or Recipient ~
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
;
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Date Admitted: 2/19/72 ~
Date Discharged: 2/16/72 ~
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Number of Days: ~ at $ 5~•57 per day= 395.99 ' '
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~ Less credits None ~ ;
M ~
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~ Amount of Lien $ 395.99 ~
,
DATED at Fort Pierce, Florida, this G~~ day of
July , 19 72 . ~
i
t
.
. (Si nature)
County Attorney
(Title)
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.
SWORN to and subscribed before me
- this ~ day of , 1~~ . -
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_ ~iotary Public State of Florida a a qg ;
IIOT~R'1 rtIBIIC. S'f11T ~FLORIDA ~T Wt6E . i
~ry COMMISSION EXPIRES JAN. 21, 1974
N,y Comrr~i s s ion Expi re s- OOtaoE~ tNRU FREO w. DtESiEIHORSi ~
RA P~H B. WILSON. STSLUCIE COUNTY dOOK~~ ~ ~
COURTHOUSE, F'f', p~ERCE, FLORIDq .
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