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35~694 f~lUC1E COUMTI ~
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NOTICE OF LIEN ~fCp~R~ ~ fpRF E~ COI?Al
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STATE OF FLORIDA ;
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COUNTY OF ST. LUCIE 35~694 {
NOTICE is hereby given that pursuant to the provisions of ~
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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 Fourteen Hundred Sixty and 94/100 {
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1460.94 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of.
Otis Green og 506 N. 31st St., 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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a= weiiare as~i~~ai,~e, n~ i~3lvw~e
Hospitals Fort Pierce Memorial
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Date Admitted: 9/8/76
Date Discharged: 9/21/76
Number of Days: 13 at $ 112.38 per day= $ 1460.94
• - Less credits None
Amount of Lien $ 1460.94
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~ DATED at Fort Pierce, Florida, this ~~j~~ day of
December , 1976 . ~
~ Si ture
~ ( 9 )
~ ~ County Attorney
~ (Title)
~
~ SWORN to and subscribed before me
~
this day of , 19~.t ~F f._ ~
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:C'lj , If.~~
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Notary Public State of Flori a at Lar~e' ,~t ;
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! My Commission Expires : 7 ~ - ~ ~ _ `
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TFfis INST~'UME'iT WAS PR~p~RFD DY . 4
RALPH B. WILS~?J. ST. L!.CS'~ G:UhlTY ~r~/~~:,.,t,;,;(,~'.
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