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NOTICE OF LIEN C:~ . ~ou~'r 'rv
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STATE OF FLORIDA ~ ~ ~ ~l~
COUNTY OF ST. LUCIE a~~~,453
NOTICE is hereby given tha~ pursuank to the provisions of ~
~ Chapter 65-2181, Laws of Florida, Acts of 1~65, the Board of County
4
CommissionerS,pf St. Lucie County, Florida, claims a lien in the
amount of Ninety-one and 43/100
91.43 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Mr. and Mrs. Robert Simmons of 1742 Ave. K, Ft. Pierce, Florida
Indigent or Recipient) (Addres~
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of Betty Jean Simmons
.
minor daughter of sai8 Mr, and Mrs. Robert Simmons
(Relationshipj
as follows:
Hospital: Fort Pierce Memorial
Date Admitted: 4/I7/75
Date Discharged: 4/18/75
:~umber of Days: 1 at $ 91.43 per day = $ 91.43
Less Credits None
Amount of Lien $ 91.43
~ Dated at Fort Pierce, Florida, this ~ r day of November ~
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f 19 75 '
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~ ~
~ (S gnature)
' County Attorney
~ - (Title)
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C SWORN to and subscribed before me '
~
,
' this ~ day of ~i~~ ~9 ~J. ~
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; Notary Public State of Florida a arge .~~~~.'c
~ My Commission Expires: ~ ~ ~ " •,~a'^ I ~ ,
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