HomeMy WebLinkAbout0840 rt. . ~ ••L•fD
~j . •~A..~~ ~
NOTICE OF LIEN ' ' ` ''T
. •
~u~ 3~ 8 sy Art ;
STATE OF FLORIDA • ~9
COUNTY OF ST. LUCIE ~129
L_ _t__ ..,,.e..~.,t tn tl~e nrnvisions Of .
Nlll'll.~'+ ia aicacii~i yiv~:: 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
amount of Seven Hundred Twenty-one and 60/100
721.60 ) Dollars against any real or personal property ' T
~
,
or interest therein presently held or after acquired by ;
x
1
,:a__~~ ~rr,,,~~ .,r 17(14 ?~~e_ ~t. Pierce~ Fla.
(qarl/ j~jQ{,ll1G Dl VVa~o vi ~ ' ~ - ' - '
(Indigent or Recipient~ (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or mai.ntenance of said Indignet or Recipient
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted: 4/22/74
Date Discharged: 5/02/74
Number of Days: 10 at $ 72.r6 per day = $ 721.60
C None
~ Less Credits
4
~ ~21..60
€ Amount of Lien $
t
~ da of
Datec~ at Fort Pierce, Florida, this Y
July , 19 74.
~ ~ -
{Sign ture)
County Attorney
. (Title) ~
~
~
S~+70RN to and subscribed before me
~
~ th i s_~_'~ d a y of , 19~.
.
~ _ ~ ^ ~ , ,
Notary Public State of Florida a Large ~~.,A,~ ~ j,.:•-:'
,
: ~
~ly Cor~smission Expires / - 7~ 'J';'~ ~ i ~•~;.y ' .
_
~ , . ~
" ~ - .
n'',,, • '
- " ~ ; • . . . . . • .
7v~g INSTRUMFNT kVfA4 PREPARED BY . ` R ~n Q
Rr1LPN 9. W1~--+ON. ST. LUCIE COUNTY '~}~~'••~~.~N: i~~~`1 vJ~~~W P~IGE V~
~ GVURTHOUSE. FT. PIERCE. FLQRIDA "
~
K _ - - - ~
~w~. . : ~ ,.~x:~