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ROGE°. PUiTR~6
NOTICE OF LIEN ClER1c C+~tCt;iT ~p~1tT
REC(?AD Vf'~~<
Qcj I~ li 1!!'13
STATE OF FLORIDA
COUNT~ OF ST. LUCIE 26'6118
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 ~elve Hundred Twelve and 80/100
1212.80~ ) Dollars against any real or personal property
or interest therein presently held or after acquired by
Ervin Jones of 2704 Avenue J, Fort Pierce, Florida -
(Indigent or Recipient) {Address)~
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indignet or Recipient
of welfare assistance, as follows:
Hospital: Fort Pierce Memorral
Date Admitted- 5/20/73
Date Discharged: 6~9~~3
Number of Days: 20 at $ 60.64 per day = $ 1212.80
~ Less Credits None
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~ Amount of Lien $ 1212.80
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Dated at Fort Pierce, Florida, this day of
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~ October , 19 7 3 .
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~ (Signature)
County Attorney
~ (Title)
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~ SWORN to and subscribed before me
this /J` ~ day of ~'G~~~-f~J , 1973 - _ ,
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Y - - ' - ° _
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Notary Public State f Florid t Large -
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• , .
- N,y Commission Expires : / - 3-~- 7 ~ " ~ ' ~
THIS INi'TRUMFPtT ~tJAS PRFPAP.ED EY
~ x~
RALPH B. ~N~LSON. ST. LUGIE COUNT
GOURTHOUSE. FT. PiERGE, FLORIDA
~ ~
° R 219 P~2279
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