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STJhTS OF FLORIDA
CWDIZY V~ bt. I+v~.i~ ~
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NOTICS fe bereby given that pursuant to the provisione of
Chapter 65-2181. Lawa of Florida, Acts,of 1965, thg Board of County
Commissioners of St. Lucie County, Floricla, claims a lien in the
amount of Fifteen Hundred aad 84/100
1500.84 ) Dollars against any real or personal property or ~
interest therein presently held or after acquired_by
~ (Name of
Katherine F. Johnson of 7503 Georc~ea Rd., Ft. Pierce, Fla.
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital- ~ ~
ization, suatenance or maintenance of said Indigent oY Recipient ~
of welfare assistance, as follows:
Hospital: Fort Pierce Memor~.al
Date Admitted: 4/23/77
Date Dischargeds 5/5/77 ~
Number of Days: 12 at $ 125.07 per d~y~ $ 1500.84
Less credits None
Amount of Lien $ 1500.84
DATED at Fort Pierce, Florida, this ~,3 day of
June , 1977 .
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CtERK CtRCUtT CON
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County Attorney
- ~U!{ 2~ ~ 21 ~M (Title)
3'7Q303
SWORN to and subscribed before me
this day of ~ ,
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Notary public State of Flo ida at ~~,a~ e ~
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1?!y Commission Expires : /-."z~ 7~". • _
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7HIf lN3TRUMENT WA9 P~EPARED er . dOOKM/~ r11~ 4~
RALPH B. WIL50N. ST. LUCS~ G~!!*!TY
COURTHOUSE. FT. PIERC~. ~LORIDA -
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