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NOTICE OF LIEN ' ~"_=~~fi~ `
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Niw 11 91Q AN''l5
STATE OF FLORIDA
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. COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant to the provisions of
Chapter 65-~181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Eight Hundred Twenty-two and 87/100 • -
822•8~ ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name, of
Rosetta Shiver of 4001 Ave. P, Fort Pierce, Florida
Indigent or Recipien t) _ (Addr~ss)
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: 6/23/75
Date Discharged: ~~2~~5
Number of Days: 9 at $ 91.43 per day= $ 822.87
i Less credits None
~ Amount of Lien $ 822•8~
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DATED at Fort Pierce, Florida, this ,t 0~ day of
November , 1975 .
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(S ignature)
County Attorney
- (Title)
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SWORN to and subscribed before me
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Notary Public State of F orida at ~ rg~j~.
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My Commission Expires: /-y-~- _ . .
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