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NOTICE OF LIEN . t~f~c ~~~twl6o~i
REccR'~ vc;,~F+E6 -
~II ~ Zi ~'T~
STATE OF FIARIDA ,
295988 ~
COUNTY OF ST. LUCIE ~
aj~~iyy ~s ~ergby given ~~g~ pursuant to t.he provisions of ~ .
lorida Acts of 1965, the Hoard of County ~
CY~apter 65-2181, Laws of F .
~
Commissioners of St. Lucie County, Florida, claims a lien in the }
. ~
amour~t.of Seven Hundred Ninety-three and 76/100
s -
~93•~6 Dollars against any real or personal property or '
interest therein presently held or after acquired by_
(Name of
_ Hubert and Wendy Medlin of Rt. 3, Box 451MC, Ft. Pierce, Fla.
~ Indigent or Recipient) (Addres,s~1
for inoney 8irectly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of Randy Medlin ~
minor son ~ of said ~uhert and Wendy Medlin
y
(RelatiQnship)
as follaws: .
Hospital: Fort Pierce Memorial
Date Admitted: 9~21~~4 ~
~ ~
Date Discharged:= ~74 ~ ~ ~
~ Number of Days:__11 at $ 72.~er day ~ $ 793.76
~
.
~
~
- Less Credits None '
~ Amount of Lien ~ 793.76
Dated at Fort Pierce, Florida, this ~ day of November ,
19 74 .
.
( gnature)
~ County Attorney
(Title) .
SWORN to and subscribed before me
~ this ~ day of ,~9~• . , -
n • . ,,~,~.~~ci:~,.. ;
. ~ ! ~;v.~~~/-~.:~ ~
• " '~#:s, . .i:',_.
Notary Public S tate of Florida Lar~e , ~
_ O;~ ' .
. . _ ' `q T . Y ~
My Co;nmission Expires: ~ 7~ ~ ~ ~;';p"~ - ~ - ~
NoYa~rr ouettG~ tl.O* 'Aj'•r~
••+~iS3 ~ri~Y~~2I:,•1978' - ~
dOtvu:C cnRU GEN~~~".!""tlll~~ci~NOfRN/t~~ER~~
TFt~S INSTRUR:F`:T \'!AS PREP~"'EO BY <Cr ~rl ~n+~" .
RALPH B. WILS!i`7. ST. LUG{i: :OUNTY
COURTHOU$E. [-T. P{ERCE. FLORfDA ~~~~1e1~~,~~5"'
d~K ~ PACE '
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