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NOTICB OF LIEN ~.W~~~ ~~u"'~
R~iCE~ °~~~f
CLER6 C:':GWT CiriJRT
• ~li~GR'' YE` IflEO
STATE OF FLORIDA ~ i~r9S9S~Zr, ~ ~ ~ j ~ ~ ~'t~
COUNTY OF ST. Luc~E 295952
NOTICE is hereby given that purauant to the provisions of
Chapter 65-2181, LaWS of Florida; Acts of 1965, the Soard of County
Cominissioners of St.-Lucie County, Florida, claims a lien in the
amouclt of Two Hundred Forty-t~b and 56/100
242.56 ) Dollars_against any real or personal property ,.f'.
or interest therein pzes~tly held or after acquired by
\
James Jacob • pf 3004 Avenue L, Fort Pierce, Florida~
(Indigent or Recipient) (Address) ~ ~
for money directly spent b~ St. Lucie County.. for the car~e, hospital-
. ~
~
ization, sustenance or maintenance of said Indignet or~Recipien~~
of welfare assistance, as follaws:
Hospital: Fort Pierce MemoriaY ~ i
~
Date Admitted- 11/12/73
. t
Date Discharged: 11/16/73
~ Number of Days:_T_ at $ 60.64 per day = $ 242.56
Less Credits None
i ~ Amount of Lien 242.56
I ' ~
f ~
~ Dated at Fort Pierce, Florida, this ~s ~ day of
~
~ .
~ November ~ lg 74
~ • '
a .
, .
- (Sig ture)
~ Count"y Attorney
(Title}
SWORN to and subscribed before me
µ _X! • ~
this ~ day of ~ , 19~
~
tixC~ti ~~'~'~-6~ . s ~ ~ ; ' •
Notary Public State of Florida La~;.?:;
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~ •~~y r~ ~R
My Co~uaission .Expires: / = ~
t~OtARi ~iJ8L7C. ~t ~ ~
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Mr tGRret;3z S';~~ ° 1478 •
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THIS IFiSTRU/fF.tJT 1P.'AS PR£PA^ED BM
RALPH B. WILSON_ 5L LUCl~ :OUNTY -
COURTHOUSE. FT. PIERGE. F LOR.DA
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