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NOTICE OF LIEN RF ORt! YE~~F
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STATE OF FLORIDA ;;52~'7
COUNTY OF ST. LUCIE
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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 Fifteen Hundred Seventy-three and 32/I00
1573.32 ) Dollars against any real or personal property or
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interest therein presently held or after acquired by
(Name of
Larry Rivers of 920 Avenue D, 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
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Hospital: Fort Pierce Memorial
Date Admitted: 8/24/76
Date Discharged: 9~~~76 ?
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Number of Days: 14 at $ 112.38 per day= $ 1573.32 ~
i Less credits None
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; ~ Amount of Lien $ 1573.32
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~ DATED at Fort Pierce, Florida, this /~j day of
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~ December ' , 19 76. ~
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~ (Si ature)
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; ~ County Attorney
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SWORN to and subscribed before me
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this ~~day of , 19~. ~
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t Notary Public State of Florid at Lar e~
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• TNIS INSTRVM~t7T \YA4 PRF°~RfD [TY '•~~/i
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