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NOTICE OF LIEN
CtERK CIRC,111~ QO{I~
' IIECO~~ VER~FI~O
STATE OF FLORIDA ~ ~ ~ ~
COUNTY OF ST, zuc~$ ~ 2s59'70 ~
NOTICE is'hereby given that pursuant to the provisions of
Chapter 65-2181, Laws of Florida,~ Acta of 1965, the Board of County
Cosaanissioners of St.•Lucie County, Florida, claims a lien in the
amount of~ Six Hundred Sixty-se~en and 04/100 ~
667.04 ) Dollars against any real or personal>property
or interest therein presently held or after- acquired by ,
Lend,West of 1314 Edward Terrace, Fort Pierce, Florida
(Indiqent or Recipient) : (Address)
for money directly spent by St. Lucie County for the careQ hospital-
ization, sustenance or maintenance of said Indignet or Recipient
of welfare assistance,- as follows :
~ Hospital: Fort Pierce Memorial
Date Admitted: 1/9/74
Date Discharged: 1/20/74 -
Number of Days: l~ at $ 6~.64 pe= day = $ 667.04
- I,ess Credits None
~ Amount of Lien $ 667.04
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~ Dated at Fort Pierce, Florida, this ~ day of
~ November Zg 74. ~ _ ,
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. ,
~ (Sig ature) •
~ County Attorney
(Title)
SWORN to and subscribed before me
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- this o~%~ ~ day of . 19~ . ~
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Notary Fublic State of Florida a La,a~-
, r~' r , •
F~~ ~
. ~Y ~4 j`_,
~ly COlitil11S810T1 EXPIIE'S S ~ ` " : 6i ~J fjp91DA At LARCi! "
~Ai tt]In~A~»ur,, t~~l~ jiN: ?i. 1979
6UNDEOJHpu~~~~C~ UNDERWRITfitS
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f ; ~ 4
~ s .5. • - , r:z ~D HY i~ ~+,y :
RALPH B. WtLS~~l. ST~LUCi~^:OUHTY ~C~•..,; yti~~[
COURTHOUSE. FT. PtERCE. FLOf21DA •
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