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NOTICE OF LIEN tOi.~RX GI~~~w~C~~n ,
RF_COR~ y~-:ctE9
A~c Il 8 ~l ~!'76
STATE OF FLORIDA
CAJNTY OF ST. LUCIE 3SZ~QQ ,
NOTICE is hereby given that pursuant to the provisions of
Chapter 65-2181, Laws of Florida, Acts of 1965, the Boarrl of County
Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Seven Hundred Eighty-six and 66/100
786.66 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
~ (Name of
Danie~ Thompson of 521 N. 13th 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
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c~r weiiare a~~isi.ai~c:e, a~ iuiiuws :
. Hospital: Fort Pierce Memorial
Date Admitted: 10/5/76
Date Discharged: 10/12/76
~ Number of Days: 7 at $ 112.38 per day= $ 786.66
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~ Less credits None
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E, Amount of Lien $ 786.66
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DATED at Fort Pierce, Florida, this ~ day of
December ~ , 1976 .
~ (Si nature)
~ County Attorney
~ (Title)
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F
E SWORN to and subscribed before me
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this ~X'~- day of ~ , 19~`' ~ • ~
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Notary Public State of Florida t~arge,
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; My Commission Expires: ~
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