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IV.~J7r7O sT~LUCIE CO~MT1?it~.
ItOCER PO~S t. ~
NOTiCE OF LiEN ~ERK c,ncu~T caMT ~
' R~~pR~ VE~tFIEO ' .
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STATE ~ OF FLORIDA ~ i?.r9S9SO ~
COUNTY OF ST. LUCIE . ~
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NvT~CE is ~~r~~y ~ive~ ~h~t gursu~nt to the gr^:,so; ~.,Q n~ ~ l-
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Chapter 65-2181, Lawa of Florida, Acts of 1965, the Board of County ;
Com~aissioners of St. Lucie County, Florida, claims.~ lien in the
, Two Hundred~Eighty-eight and 6~/100 ~
amount of ~
~ ~ ~
288.64 ) Dollars against any real or personal property • i
~
or interest therein presently held or after acquired by.
GladYs Mae Adams of 402 N. 8th St., Apt. B, Fort Pierce, Fla. ~
(Indigent or Recipient~ (Address)
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: g'
{
Hospital: Fort Pierce Memorial
~ Date Admitted: = 27~74
Date Discharged: 8/31/74
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Number of Days: 4 at.$ 72•16 per day = $ 288.64 4
~ - Less Credits None
I ~ _
I
I ~ Amount of Lien $ 288.64
Dated at Fort Pierce, Florida, this ~j~„ day of
November ~ ~g 74 -
.
(Sign ture)
County Attorney ~
. (Title) S
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SWORN to and subscribed before me
~
- this , v~S day of ~'c,~--t.~2 1~
~ . 19~. r': .
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Notary Public State of Flori at La~g$ ~~,~t,=- • j-' r:
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My Commission Expires : i - ~ - 7~ ~ ' : r -4 .f,~.- J
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NOTARY PU6LIC STA1E G~ ~i ~ -
MY ~UM.~,._ ~x?lifA! ~k M..V~~~~ v ' ' ~
l10ND~~ 1~'.R~, --cv v!t ~NS ~~~i`,~'• ~
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~,~'~y'fy'~~'Fr,;;.,,: , . 1
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TH19 IpiSTRUFSF~°T \4P.5 Pr ."r' •^J CV
RALPH B. 4YIL5!7i~. S'f. L,'~, '.:'~:~TY
COURTHOUSE, PT. PIERC:E, FLOF21DA
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