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~ NOTICS 0~' LIEN
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STATE OF FLORIDA ~ ' ~ ~
~~+,n?rnv nF ~~r_ LUC18
NOTICE fe hereby given tbat pursuant to the provfaions of
Chapter 65--2181, Lawa of Florida, Acts of 1965, the Board of County
Commissionere of St. Lucie County, Florida,.claims a lien iri the
amount of T~irteen 8undred Forty-eight and 56/I00
1348.56 ) Dollara against a~y real or personal property or
interest therein prese~tly held or after acquired by
~ (Name of
Joe Louis Simon of 4201 $an Diego Ave., Ft. Pierce, Florida
Indigent or Recipient) (Add~cess)
for money directl~ apent by S't. Lucie County for the care, hospital-
ization, sustenance or maintenance of.said Indigent or Recipient '
of welfare aseistance, as followss
. Hospital: Fort Pierce Memorial
Date Admitteds 3/~6/77
Date Discharqed: 4~~~~7
Number of Days: 12 at $ 112.38 per da~ $ 1348.56
~ Less creait8 None
Amount of Lien $ 1348.56 ~
DATED at Fort Pierce, Florida, this 1,3 day of
.Tunc+ • 19 77 .
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Il00ER f01TA~ • {
pFCeaRVEAaf~CO , ( iqrjature)
~ 23 ~ County Attorney
3~'0312 ~Title~
SWORN to and subscribed before me
this ~-ji4~ day of 19~~ '
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Notary Public State of Florida
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My Commission Expires s 7~~< t
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TFt1~ tNSTRUMFt~T WAS PREPIIP.ED ey ,
_ RALPH H. WILSON. ST. LUCIL- C~UNTY
COURTHOUSE. FT, p1ERGE FLOR[DA Q~
~ ROOK P14CE
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