HomeMy WebLinkAbout0836 ' . c{- C' ~
~
?i~Ea ~h~~ afc~soeo
ST.lUC1E :JUNTY FLA.
NOTICE UF LIEN RO~E JITRAS ,~~A
CtE~~ i • "U!T COURT -~t~~
n~rn~ ~ 1C:, sIC)~~..~... C''
V
STATE OF FLORIDA J11L 30 8 s~ AH ~ 1~ • •
COUNTY OF ST. LUCIE ~+W125 ,
~
..,...,.,.Q ti,e..e},.. ~.A*+ t~,at nursuant to the prOVisioRS of ~
~~v~i"v.r r..c ~'__~..1 J=, _ ~ _ .
Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the
" 4
amount of ~o ~ndred Eighty-ei9ht and 64/100 - ;
~
288.64 ) Dollars against any real or personal property ~ _
or interest therein presently held or after acquired by
R~,~,,pr~ ~i~~~~Q~ ~,f 2803 Avenue R, Fort Pierce, _Florida t
(Indigent or Recipient) ~ (Address) :
t
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 Memorial
Date Admitted: 5j~j~4
Date Discharged: 5/8~74
Number of Days: 4 at $ 72•16 per day = $ 288.64
i Less Credits None
~
~ Amount of Lien $ 288.64
~ ~
~ Dated at Fort Pierce, Florida, this ~ y~ day of
~ July , 19 74
~
(Sign ture) •
County Attorney
(Title) ~
~ .
~ SWORN to and subscribed before me
^ -~J , 19 .
~ this y day of
~ ~ '
~ t~_ ~,l/ ~L L~ ,
~ "'I'
Notary Public State of F orida a arge
. G
= M Commission Expires ~ J ~~"7~ - ~
Y _ _i s~_•A
, ~ ; Q
.a • -
~ s f~ U t31%~
't.:_ i.
THIS INS7'RUMENT 1bIA3 PltEPARED DY . '..1' '••^1~~.: ~
_ RALPH B. WILSON. ST. L.UCIE COUfVTY •;;.~CF 'Zt` O R~ Q~
, fn l'J• PAGE VW
.•CmURTHOU6E FT. PIERCE, FLORIDA ' ~~~~i~~,,,,~~~'`` gOOK
~
~
-
~ - ~
.~m45~ . . . _ . _ . . .ai_ , .w , u