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NOTICB OF LIEN ~ E~'` ~•~?~j C~JRT
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STATE OF FLORIDA 3(~Q~~~g~ _
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COUNTY OF ST. LUCIE ;
NOTICE is hereby given that purs~ant to the provisions of
Chapter 65-2181, La~+s of Florida, Acts of 19G5, the Board of County ~
Commissior.~rs of St. Lucie Count}-, Florida, clairts a lien in the S
amount of Ten Hundred Sixty-seven and 04/100
1067.04 ) Pollars again5t any re~l or personal proper*y or
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interest tl~erein presLntl~- held or after acquired by _ `
{Name of
Evelyn Cleveland of Rt. 1, Box 440, Lot 68, Ft. Pierce,
Indigent or Recipient) (Address) F orida
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for money directly spent t,I St. Lucie County for the care, hospital- ~
ization, suster.~.r:.~e or mair.tenance of said Indigent or Recipient
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of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
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- Date Admitted: 1/23/76
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Date Discharged: 2~6/76 #
12 days paid ~
Number of Days: 14 at $ 88•92 per day= $ 1067.04 ~
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i Less credits No~e ~
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` Amount of Lien $ 1067.04
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~ . DATED at Fort _Pierce, Florida, this Z•Z JI~ e day of
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~ July , 19 76 ~ <
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SWORN to and subscribed before me ~
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th i s ~ a~h..~ d a}~ o f , 19 .
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Notary Public State of Florida t Large . ~ t
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