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iT. LUC~E ~~UNTY f~1
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NOTICE OF LIEN C~EF K:,, ...u:~ C;,t,Rt
nc~pr.-, y~~ '~E)...~~ /y
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STATE OF FLORIDA 3`~0~~~~
C0~[1NTY OF ST. LUCIE s
;
NOTICE is hereby given that pursuant to the provisions of
Chapter G5-2181, La~:~s ef Florida, Acts of 1965, the Board of County s
Commissioners of St. L~:c~~~ Co;:r.t~.•, Flor?da, claims a lier• in the '
~
amount of Ten Hundred Sixty-seven and 04/100
I067.04 ) Do] i~ - i::.-t anj: real or pers~nal ~r.oazrt~T or
interest tl~erein presentl~.• !-~~_-lci oz after acquired by ;
(Nam4 of '
f
George A. Smith of 109 N. 39th St., Ft. Pierce, Florida ;
Indigent or Recipient) (Address) '
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for money directly sp~i~~ St. Lucie County for the care, hosgital-
ization, susten:.3nce i: ~~na~-:ce o~ said Indigent or Recipient
of welfare assistance, as follok•s:
Hospital• Fort Pierce Memorial
e
Date Admitted: 3/31/76
Date Discharged: 5~14/76 ~
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12 da s a id ~
Number of Days: 44 at $ - per day= $ L067.04
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Less credits None !
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~ Amount of Lien $ 1067.04 ;
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l DATED at Fort Pierce, Florida, this ZZ~11~ day of =
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~ July • 1976 - ;
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s
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~ (Si nature) ~
S
~ Countv Attorney
~ (Title)
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N SWORN to and subscribed before me
,'~i i ~
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~ this ~a,~ d day of , ~9~.
~ . „ 4
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~ Notary Publ ic State of F1 ida at~ Earge ~ ~ ~
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~ ;~iy Com~.~i < < i c~., E•fpi: e~ _ 7~ % : `
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