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NOTICE OF LIEN P~ ~tfF~ f: :..u:Z CCtf~tt
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Jw.13 9 v2 AN '76
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STATE OF FLORIDA
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
Cammissioners of St. Lucie County, Florida, claims a lien in the
amount of Ten Hundred Sixty-seven and 04/100
1067.04 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
~ (Name of
Gloria Blake of 3111 Avenue I, Ft. 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
of welfare assistance, as follows:
~ Hospital: Fort Pierce Memorial
Date Admitted: 2/19/76
Date Discharged: 3/9/76
12 da s aid
Number of Days: 19 a$ per day= $ 1067.04
Less credits None
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i Amount of Lien $ 1067.04
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~ DATED at Fort Pierce, Florida, this x,Z day of
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~ July , 19 76 .
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~ (Si ature)
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5
County Attorney
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~ (Title)
~ SWORN to and subscribed before me -
~ this ~~it( day of , 1,9~: .
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7P ~-e- ~'a.,c ` ` ' ' ' ~ .
~ Notary Public State of ~'lorida t Large _
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~ My Commission Expires: 7~ ~
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