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NOTICE OF LIEN OIEIIK CitlCUlt COUIIT
RECORD VEA~~~EO
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STATE OF FLORIDA IGrv~~SS~, s
I
CCUiTY OF St. LUCIE •
• ~OTICE is hereby given that pursuant to the provisions of
Cr•apter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Co:n~:issioners of St. Lucie County, Florida, claims a lien i~ the
i
amount of Eleven Hundred Eighty-seven and 97/100 '
1187.97 ) Dollars against any real or personal property ar
interest therein presently held or after acquired by
(Name of
Fred Donaldson of 602 N. 32nd St., Fort Pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by ~t. 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: 3/15/72 ~
. ~
Date Discharged: 4/5/72 . ~
21 J 56.57 er da 1187.97
Number of Days: at $ p y= $
~
~ Less credits None '
~
Amount of Lien $ 1187.97
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DATED at Fort Pierce, Florida, this ~ day of ~
July , 19 72
.
, (S ignature) •
County Attorney
~ (Title) -
SW02~~ to and subscribed before me ~~t
x •
t'r.is l/ ~ day of . 19Z~.
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~ , ~ • ~ .
?C • . . ~
~iotary Public State of Florida at L rge •
NOTARI PUYII~ STA1E 9F FLORIDA AT LARIiE ' ,
MY COb1hltSSION EXPIRES JAN. 21. 197~ '
~.y Commission Expires: ~ONpEB IHRII fRED ~ DlESTEIHORST
~ THIS INSTRUMF~~T WAS PREPAREO S1f (~O~ ~
~ RALPH B_ WILSO:'•J. ST !~'CIE COUNTY a~OK~ PAGE y
GOURTHOUSt. FT. PIERGE. FLORIOA
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