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ROCER p+)iTqAa
NOTICE OF LIEN P.ECGRb vE ~~i E~ COURt„~ ~
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STRT~ QF FL•~R?DA ~~~~(?3 -
COUNTY OF ST. LUCIE ~
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 Seven Hundred Eighty-six and 66/100
786.66 ) Dollars against any real or p~raonal property or
interest therein presently held or after acquired by
(Name of
James Moore of 1723 Avenue F, Fort 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 ~
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted: 10/5/76 ~
Date Discharged: 10/12/76
Number of Days: ~ at $ 112.38 per day= $ 786.66
' • Less credits None
~
~ Amount of Lien $ 786.66
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- DATED at Fort Pierce, Florida, this day of
December , 19 76. ~
(S"gnature)
. County Attorney
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~ SWORN to and subscribed before me '
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th i s ~ da y o f ~.,1~C'!~lyt.~i~ , 19~. ~
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Notary Public State of F1'ori a at.Lar~e. ~
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~ My Commission Expire~s: !-Z/-~~/r''~'~~'''+' ~ '
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