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NOTICE OF LIEN ~E ~,~y ~t
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~c Il 9 z9 ~M'76
STATE OF FLORIDA
COUNTY OF ST. LUCIE 352695
NOTICE is hereb iven 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 One Hundred Twelve and 38/100
112/38 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Wesley Dorsey of 2306 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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oi welia~e a~~i~~a~t~e, a~ f~Z~c::~:
Hospital; Fort Pierce Memorial s
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I Date Aclmitted: 7/19/76 ~
Date Discharged: ~~20/76
Number of Days: 1 at $ 112.38 per day= $ 112.38
~ Less credits None -
i ~ Amount of Lien $ 112.38
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~ DATED at Fort Pierce, Florida, this day of
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~ December , 19 ~6.
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~ (Sig ature) ,
i ~ County Attorney
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SWORN to and subscribed before me -
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this day of .
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j Notary Public State of Florida a Lar~e,:~
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; My Commission Expires: /-~'~"'7p ~ ' . .
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THIS INSTRUAT~••~ tNAS PR~PRRED EfY ~ /~r~
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