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33(~(~~2 NOTICE OF LIEN 'r" ~CURT ~`~t ~r i
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Ma~ 18 IG os ~N''16 -
STATE OF FLORIDA
COUNTY 4F ST. LliCIE . ~~~~~2 =
. NOTICE is hereby given that pursuant to the provisions of
CY~apter 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 Nineteen Hundred Twenty and 03/100
1920.03 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Evel~n Cleveland of Rt, 1, Box 440, Lot 68, Ft. Pierce, Fla.
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 weZfare assistance, as follows:
Hospital; Fort Pierce Memorial
Date Admitted: 12/26/75 ~
Date Discharged: 1/16/76
Number of Days: 21 at $ 91.43 per day= $ 1920.03
Less credits None
Amount of Lien $ 1920.03
~
DATED at Fort Pierce, -Florida, this f g~~ day of
~ March ~ 19 76 .
.s
(Si nature) ~ -
_ County Attorney
• (Title)
SWORN to and subscribed before me
this ~ day of , 19~... ~
. - .
. . '\l ~Y ~ . .
QJ O~. - ' .
L : • r = .
Notary Public State of Flor' a at Large ;
My Commission Expires : 7~ ~ ' I ~ ~ v
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z?,,s ~~~,Tr• - - _ . , . .Y ~ - nQ 25U fAGE ~
RALPH B. W!i_.!_'! ~.T. ,_:r:.:_= : • ..TY
COURTHOUSE.. Fi. P~:-~:~-:=. F~iii.::A
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