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NOTICE OF LIEN
STATE OF FLORIDA 3s,~~c~
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CCIUNTY OF ST. LUCIE
NOTICE is hereby gfven 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 T~?o Hundred Twenty-four and 76/100
224.76 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Mary Dubberly of Rt. 3, Box 451 HW, 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
of welfare assistance, as follows:
Hospital: Fort Pierce Memorial
Date Admitted: 1/3/77
Date Discharged: 1/5/77
Number of Days: 2 at $ 112.38 per day= $ 224.76
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~ Less credits None
Amount of Lien $ 224.76
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~ $r .
~ DATED at Fort Pierce, Florida, this ZL ~ day of
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March , 19 7~ .
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FIlEO AND ItEC0ii0ED (S ' nature)
ST. ROCER POt?RAS `A
! CIERK CIaCUiT C00RT ~ County Attorney
NECORD VEit~F1E0~.-----
(Title)
APR 6 10 ls aH'71
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3 SWORN to and subscribed before me ~5~~ .
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~ this o2~ day of ~Ji!!2~J . 19~. '
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Notary Public State of Flori at Lafg~:~
~ M Commission Expires ~97 f;, : i
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~ TH~S tNSTRUMFt.T \JA4 PREFARED BY
~ RALP'i B WILSUN. 5T U~C7E COUNTY c~,
GOURTMOUSE. FT. PIERGE. FLORIDA ~
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