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NOTICE OF LIEN ~T~Gi~t Fo~TR11= ~T ,
~Fe~p~ vEk+' f0 ~OU
STATE OF FLORIDA ~95953
ilor 15 I i 2~ AM't~l
COUNTY OF ST. LUCIE
~ ~95953
NOTICE xs hereby given that purauant to the proviaioris of
Cbapter 65-2181,,LaNS of Florida,~ Acts of 1965, the Boa~cd of County
~
Commissioners of St.-Lucie County, Florida, claims a lien in tHe !
a~ount of Eight Hundred Forty-eight and 96/100
:
848.96 ) Dollars against any real or pezsonal property '
or interest therein presently held or after acquired by _
John Kurtz of 3432 Abbott St „ Fort Pierce, Florida
(Indigent or Recipient) (Address)
for money directly spent by~St. Lucie County for the care, hospital-
d
ization, sustenance or maintenance of said Indignet o~t Recipient ,
~ ;
of welfare assistance, as follows: -
~ Hospital: Fort Pierce Memorial
Date Admi~ted: 12/12/73 -
~ Date Discharged: Z2~26/73 _
Number of Days: 14 at $ 64.64 per day = $ 848.96
~ I,ess Credits None
I Amount of Lien ~ 848.96
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~ ~ `
~ Dated at Fort Pierce, Florida, this ~ day of {
November ~ lg 74. ~
.
.
-(Si.gn ture)
. ~
County Attorney ~
(Title)
SWORN to and subscri}~ed before me
~ 1(_/~
~ this v~~ day of ~~.-v~ . 19~•
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Notary Public State of Florida t Larc~. ''~r'~~~'~
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~ My Commission Expires : / Z~- - ~ ;f o,`, .
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TNlS 1NSTRU*1F*7T ~lVA4 PRFPA~'ED HY ,,.~;~JC~:~~~.~~~~5 ~
RALP!-i B. WILSON. 5T LUCf~. 'nUNTY ii~~~r.~. •
COURTHOl3SE. FT. PtERGE. Ft-ORiDA .
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