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NOTICE OF LIEN Ctf~K t:~ :t~t7 COURT ;
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STATE OF FLORIDA {
COUNTY OF ST. LUCIE ~~~4
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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 Thousand Thirty and ?2/100
3030.72 ) Dollars against any real or personal property '
or interest therein presently held or after acquired by
_ T a ~ ~ ~~.Q~,.,o _r. t= Pierce. Florida 4
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(Indigent or Recipient) (Aaax~ss~
for money directly spent by St..Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indignet or Re~ipient
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted: 5/1/74
Date Discharged: 6~12/74
Number of Days: 42 •at $ ~2•16 per day = $ 3,030.72
~ ~ ~ Less Credits None t
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~ $ 3, 030. 7~-- t
Amount of Lien
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Dated at Fort Pierce, Florida, this day of s
July ~ 19 74 ;
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(Si nature)
County Attorney
(Title)
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e~ SWORN to and subscribed before me
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~ this ~ day of • 19~
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A..J
~ t.otary Public State of lorida at arge ~~t.;;'~'""'-•~..;~-~,
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My Comrr~iss ion Expi res : . r• . . ~ ~i~-.
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THti INSTRUMENT 1NA3 PREPARED SY "y•~• ~ ~ v ~ ; `O R Q
RALPH B. WILSON. ST. WCIE COUNTY lr'• 6GOK~ PACE v~
COURTHOU6E. FT. PIERCE. FLORIDA ~ ` • • • ~ ~
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