HomeMy WebLinkAbout5822 2455'76
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2455'76
COL'\TY Cr 5`.'. LUCI :
\0`l?"C~ is :~ereby given tha~ nursuant to the provisions of
C::~~:.~~- GS-~~ 31, La~ti~s of Florida, Acts of 1965, the Board of County
Co::.::issi~ne~s or St. Lucie County, Florida, claims a lien in the
a~~ou:~t o~ One Hundred Ten and 12/100
110.12 ) Dollars agains~ any real or personal property or
ince_-est therein presently held or after acquired by
(Name o f
Sam & Mattie Johnson of 111 Hilton Dr., Ft. Pierce, Florida
Indigen~ or Recipicntj (Addres~
for mor.ey Cirectly saent by S t. Lucie County for the care, hospital- _
~
iza~io:~, suste:.ance or maintenance of Hlillie Johnson ;
. ;
minor son of said Sam & Mattie Johnson ~
(Relstiqnship)
as ~ol~ows:
hospital: Fort Pierce Memorial
~
~ Date ~:umitted: 9/16/72 , '
~
~ Date ~isc;~arged: 9~18~72 }
~
~
; tiu.~ber of Days: 2 at $ 55.06 per day = $ 110.12 ~
~ None
s Less Credits
~
E
~ Amount of Lien $ 110.12
~
~ Da~ed at Fort Pierce, Florida, this ~ day of January ~
~
~ lg 73.
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~ ~
~ •
3
~
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~ (S'gnature)
~
~ County Attorney
(Title)
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r: :,;•:O:t`: tc ar.a su:,scribed before me `
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es TH'S INSTP.U!NF~:T \'.'AS F?^~AqcO ry .
; RALPH B. WILS~~.`.;. ~ - ; ~ C;~ ~r.;Ty ~ ~
COURTHOUSE. FT. Pi~RG~, FLUi-2;Dq e0~~ ~6 -
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