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NOTICE OF LIEN
STATE OF FLORIDA ~~~"~+~1
COUNTY OF ST. LUCIE •
NOTICS fe hereby given that pursuant to the provisions of '
Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
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Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Five Hundred Sixty-one and 90/100
561.90 ) Dollars against any real or personal property or
interes~t therein presently held or after acquired by
(Name of
Roxie Smith of 419 N. 10 th 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
of welfare assistance, as follows:
iiospital : Fort Pierce Memoria 1
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Date Aclmitted: lI/15/76 ~
Date Discharged: 11/20/76
Number of Days: 5 at $ 112.38 per day= $ 561.90
; Less credits None
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~ Amonnt of Lien $ 561.90
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~ DATED at Fort Pierce, Florida, this ~L~} day of ;
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~ April 19 77
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~ 3~~261 = 3T[~~QpGN~Y Fu. (Si nature) .
aoceA Po~Ta~s ~
~ ~'.E~R v'~CUIT CCVRT ~
~ -,r;c~~„~ County ~Attorney
~ ~/nzs ~ 36 PN ~~1 (Title)
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SWORN to and subscribed before me ~
this u day of , 19~.
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Notary Public State of Flor a at LarcJ@,•'t ~
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