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NOTICE OF LI£N ct =~K"E, Fjs
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- M~ut I b 10 os AN ' 16 ~
STATE OF FLORIDA s
3300E;~3 ~
COUNTY OF ST. LUCIE ~
. NOTICE 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 Six Hundred Forty and~01/100
640.01 ) Dollars agains~ any real or personal property or
interest therein presently held or after acquired by
(Name of
Willard Thomas of 907 N, 13th st., Fort Pierce, Florida -
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital- t
ization, sustenance or main tenance of said Indigent or Recipient
of welfare assistance, as follows: ~
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Hospital: Fort Pierce Membrial ,
Date Admitted: 12/6/75
Date Discharged: 12~13/75
Number of Days: ~ at $ 91.43 per day= $ 640.01
Less credits None
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Amount of Lien $ 640.01 i
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~ DATED at Fort Pierce, Florida, _this ~ ~ day of
March ~ Ig76 ~ Q:
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• .
(Si nature)
County Attorney
(Title)
SWORN to and subscribed before ine
this day of ~u~e-c~~ , 19~. ~
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• Notary Public State of Flor a at Lar~~. : ~
My Commission Expires : Z/ - 7Y I ~ ~1 f"' ~
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