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NOTICE OF LIEN f f~
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STATE OF FLORIDA
COUNTY OF ST. LUCIE ~~ZSSS
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 One Hundred Sixty-four and 50/100 ~
164.50 ) Dollars against any real or personal property or
- interest therein presently held or after acquired by
(Name of
_ Willie Nickerson of 1701 No. 12th St., Ft. Pierce, Fla.
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
c~f wPlfarP assistance, as_follows- "
Hospital: Fort Pierce Memorial ~
Date Admitted:
Date Discharged: ~t-patient care
Number of Days: at $ per day= $ 164.50
visits to the Emergency Room on g/13/76 (2) Less credits None
' and 12/31/75 Amount of Lien $ 164.50
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~ DATED at Fort Pierce, Florida, this /~i day of
~
{ December ' , 19 76 . ~
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~ (Si ature) '
~ - - County Attorney
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~ (Title)
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' SWORN to and subscribed before me
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this ~ day of ~/~.(',~ifh~~,l~J . 19 s';s.:
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~ Notary Public State of Florid at Large~~;~ ~
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