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NOTICE OF LIEN i'~ '`'~~~`~T r~1F '
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STATE OF FLORIDA ~2~A~$ :
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COUNTY OF ST. LUCIE ~
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NOTICE is hereby given that pursuant to the provisions of ;
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Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Fourteen Hundred Sixty-two and 88/100
1462,88 ) Dollars against any real or personal property or ~
interest therein presently held or after acquired by ~
(Name of
Jessie Booker of 423 No. 14tii St., Ft. Pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows: ~ '
Hospital: Fort Pierce Memorial
Date Admitted: 8/9/75
Date Discharged: 8~25/~5
Number of Days: 16 at $ 91.43 per day= $ 1462.88
Less credits None
' Amount of Lien $ 1462.88
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DATED at Fort Pierce, Florida, this iri~ ~ day of
November ~ lg 75.
(Si nature) ,
County Attorney
(Title)
SWORN to and subscribed before me
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this ~ day of ~?rr<-' rn, ~ ~ . 19 71.
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Notary Public State of Florida Large =
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My Commission Expires : % ' ~Y~~ " I
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~N~s ~NS'TP.iJMFNT lYl~4 pREpARED BY
RALPH B. 'i!(LSOC.r L'.;(~;Y ~CUNTY ~
` COU17 tF-{;,'.: F ~ ~ FLORIDA
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