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STATS OF FLORIDA ' ~
COUNT'Y OF ST. LUC~ ~ ~
NOTICE f.e hereby given that pureuant to the proviaione of
Chapter 65-2181, Laws of Florida, Acte of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claime a lien in the
amount of _Twenty-four Hundred Thirtv-eiqht and $8/100
2438.86 j~llars against any real or personal property or .
interest therein presently held or after acquired by
(Name of
Gerald Humes of Tumblin Klina Rd.. Ft. Pxerc_
e. Florida
Indigen~ or Recipientj ~ (Address)
for money directly spent by St. I.ucie County for~the care, hospital-
~izatian, sustenance or n?aintenance of said Indigent or Recipient ~
of welfare assistance, as followe:
. Hospital: Shands Teaching
Date Admitted: 3/22/77
Date Discharged: 4/15/77
Number of Da 8= Z days at id203. 24
y $ per day= $ 2438.88
Less credits None
Amount of Lien ~ $ 2438.88
DATED at Fort Pierce, Florida, this ,Z 3 day of
~ June , 19 . .
E
- ROOEIt ~0 A!
c~.ERK c~RCU~ c - •
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. (Sig ature)
~N 1~ 19 ~ ~~7 Countv Attornev
a~"~~5 (Title)
SWORN to and subscribed before me
this ~.3 day of ~ , 19~. '
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Notary Pub c State f F orida at i~ar~qe" ~
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My .Com~aission E ires: /-1/- j~ p'E:j,`.:~'
, ~ " BOOX~~ PAGE 4~~
~ i TNIa INSTP.UMfi':T K'A4 PREPARFO DY
: RALPH B. WILSON. ST. LUG1~ CUUNTY
COURTHOUSE. FT. Pf~RGE, FLORIDA
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