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!!~?1'IG~ A!' LIEl1
8~1?Ti O! lLORIDI?
~ ~;`~.~;'(j2
oov~r or sr. ~acYa
~10'tIC~ is hereby qiv~n that purauant to th• psovi~lons ot
Chapte= 55-218I, LaMr~ ot ~larida, Acta ot 1965, th~ Ha~ard ot County
Ca~i~sic~er~ ot 8t. Luci~ County. ~lorida, claim~ a li~n in th~
a~ount of Five Hundred 3ixty-one and 90/100 ~
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~s 561.90 ) Dollara againat any r~al or ~Z1Gfli1 pTOp~rty ot
int~r~st th~raie pres~~tly h~ld or after acquisad by
~Naw~ ot
Harve S lls ot 1108 Orar~ge Ave., Ft. pierce, Florid
In~ligent or Recipi~nt (1lddres~l
toz money directly •p~nt by St. Lucie County tor th• care. ha~pital-
isatio~, su~tenence or ~oaintena~c~ of Eli4abetb Id~ry Sp~lls ,
minor daughter of said Harvey Spells ~
~Aelation~hip)
a• tollavs:
Hospital: Fort Pierce !lemorial
Date Adsitted: ~~2~/76
~ Date Discharqed: 8/1/76
Nwnber of Days:= st $ 1I2.38 per day e S 561.90
E Le~~ Credits ~O~e
~ Aoaount of Lien S 561.90
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Dsted at Fort Pierce, Florida, this ~ day o! ~tob~er ~
1976 . i
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Ctf~~Ctl~ Lil~~i ~
*~~r~,. c ~r•£~ ~'~t .
-1""' (Si turt)
~ ~ ~ ~PM'~i
r Cowrty Attorney
a3~~ (Ti t le )
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~ 81ii0R~l to and sub~cribed be tore me
thf • day ot ,19,~•
. . , 4~.•. :s ~ ~ .
b~~...~.L,~. - . , r
Notary Public Sta~e of Flori at Las~: i;~s -
- 7 = : .
My Co~i~~ion Expir~~: / r t~;
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~ ~259 fA~E 7~.~