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. NOTICE OF LIEN ~~tN~' ~
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STATE OF FLORIDA -
3300~~
C04JNTY OF ST. LUCIE -
NO'1'ICE is hereby given that pursuant to the provisions of ~
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 TWO Thousand Sixteen and 96/100
2016.96 ) Dc~llars against any real or personal property or
interest therein presently held or after acquired by -
(Name of
Walter Mae Gibson of 1607 Avenue D, Fort 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 ~
s
of welfare assistance, as follows: ~ '
Hospital: Shands Teaching Hospital ~
Date Admitted: 12/1/75' .
Date Discharged: 12/17/75
(allowed)
Number of Days; 12 at $ 168.OS per day= $ 2016.96
~
j Less credits None '
` Amount of Lien $ 2016.96 t
€ ~
~ ~ 4
~ ~ DATED at Fort Pierce, Florida, this /O day of _
~ March , 19 ?6. ~
.
~ (Si ature)•
~
~ County Attorney
~ (Title)
~
~
~ SWORN to and subscribed before me ~
~ da of ~'~.~c~v , 1. 9 . .
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Notary Public State of Florida at Larg~
~ My Commission Expires: ~
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