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NOTICE OF LIEN
STATE OF FLORIDA
COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant to the provisions of
Chapter 65-2161, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Fifteen Hundred and 84/100's
1500.84 ) Dollars against any real or personal property .
or interest therein presently held or after acquired by
Clarence Bateman Taylor of 1606 Ave. D, Ft. Pierce, FL
(Indigent or Recipient) (Address)
for money directly spent by St. Lu~ie County for the care, hospital-
ization, sustenance or maintenance of said Indignet or Recipient ~
~ of welfare assistance, as follows:
Hospital: Ft. Pierce Memorial
Date Admitted: 9~2~~~~ -
10/8/77~ ~
~ Date Discharged:
~ Number of Days: ~2 at $ 12 _5 07 per day = $ 1500.84
Less Credits none
f
~ Amount of Lien $ ~~T~'~
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~ .
; Dated at Fort Pierce, Florida, this ~ day of
[
; ~ 19_]~• ~ ~ ~ ,
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igna ure)
(Title)
r
~ SWORN to and subscribed before me fiLfO AND RECUROEO
ST. Ll1CIE COUNTY F11~.
" RQC~R POITRAS
~ this 9~ day of , 19 78 " ~~-f ~K.s F E~ Co t
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~ ~IAR I O ~ 32 PM'~
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~ Notary Public State of Florida La~ 3~sa~s
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~ My Commission Expires : Jan 21, 1982 ; v, ; 'o : u~
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~ ~tt J. ~ ~ : ~ . . : ~ eo~ 283 P~ 982
~ Ac~ninistrati,on sldy. ,Aoom l06 ,
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~ Ft. Pieroe,JFlorida
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