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. AMSND$D Y*~
. NOTICS LIEN
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STAT$ OF FL4RIDA
COUNTY OF ST. LUCIS -
NOTIC$ ia hereby given that pur8uant to_the provisions of ,
Chapter 65-2181, Laws of Florida,.Acts of 1965, the Hoard of
County Com~aiesioners ~f St. Lucie County, Florida, claims ~ lien
i~ the amount of Five Hundred Twenty and 58/100 ~ =
520. 56 Dollara against any real or personal property or _
interest therein presently h~ld or aft~r acquired'by
~Name of
of 511 N. 19th St.~ Ft. Pier~e~ F~1,~_ -
indigent or recipient} ~Address)
for money directly spent by St. I.ucie County for the care, hospi-
talization, sustenance or maintenance of said indigent or recip-
ient of~welfare assistance, as follows: ~ ~
Hospital: Fort Pierce Memorial ~
~ } Date Admitted: 1/26/7~ -
Date Discharged: 2~2~~6
Number of Days: ~ at $88.92 ~r Day 622-.44 ~ _
F
- I,ess Credits ~ 10I.86 .
' . Amount of Lien ~ 520.58
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i DATED at Fort Pierce, Florida, ~ this th day of ,,1,,,~,__,
(This Amended Notice of Lien supereedes.Notice.of Lien
19 dated May 24,~1977 and rggorded in OR k 268,page 1915)
~ ) _ A
~ •
. ignature)
County Attorney , .
(Title)
SWORN to and subscri ~ before me _ '3'~~~
= thf s~~day of , 19L,~ • R ~ ~ ~ '
= - - CIEPK CIACIlt1 Ca1RT
; ~ Y[81f1ED
Notary Public Stat~~~;,~''~or at Large Z1 26 ~s'~ ' ~
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