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IN THE CIRCUIT COURT OF THE TEN'T~-i JUDICIAL C1RCUIT ~
IN AND FOR po~c COUNTY, FLORIDA.
STATEMENT OF CLAIM ~ ~
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Punuant ro Ssction 27.56, Fbride Statutes (1972), J. O. JOHNSON, s: Pubiic Defender for the Tsnlh
Judidal Circuit of Florida, fil~ this, a Statsrr~ent of Claim against RICHARD HARRY EMERSQN .
M,hose addreu is 2502 T mar nd T]riv - Nc~rth ~each An~_ .A;~t_ 8 Fnrt Flgre~ ids .
and in favor of the Stats•of Florida, in the sum of ~ 300.00 ~~ara), punuant to Court Order .
dsted September 2 ~ ~9Z?, for s~rviaes re~dered sa Public Defender for the abov~ named _
Oefsndant in Caae Na. CF77-?96 ~
up ro and including ~Ptember 2 19 7? ~n ~ Circuft of Polk .
Counry, Florida. -
This ~ptember 12 197?
O. H
Pub c ende~ •
~
Sworn to and subaibed before me at .
Bsrtow, Florids, this ~th day r`~'±
~ September t97 ? .:~~t~i{sr;~;,~~=:
~ ~ ~S ~a5~~ 4y . - _
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N A Y PUBUC/State ~ i t ~
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.:~.`d ~ ~ :
2/27/81 ~ ~
My Commission Expires: " ~ ~j :
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Retum To: ~ f~~tt~~ei~t'"~
r JACK O. JOHNSON, Public Oefender
` 495 N. Carpenter
~ Bartow, Fbrida 33830
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SEP 15 PN'~T
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