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4:;5865 :
NOTICE OF LIEN
STATE OF FLORFDA .
COUNTY OF ST. LUCIE
NOTICE is hereby given that pursuant to the provisions of •
Chapter 65-2181, Laws of Florida, Acts~of 1965, the Board of County ~
Commissio~ers of St. Lucie County, Florida, claims a lien in the ~
amount of Ei~ht Hundred Ninety-five and no/100's
895.00 ) Dollars against any real or personal property
or interest therein presently held or after acquired by
Rilev Givens of 115 Gotham Drive, Ft. Pierce, FL t
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(Indigent or Recipient) (Address) ~
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for money directly spent by St. Lucie County for the care, hospital- ~
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ization, sustenance or ~?aintenance of said Indigent or Recipient
of welfare assistance, as follows:
Hospital: Lawnwood Medical Center ~
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Date Admitted• 11/5/78
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te Dischar ed: ~11/l0/78 ~
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Number of Days: 5 at $ 179.00 Per day = $ 895.00 .
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E ~ Less Credits none
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~ Amount of Lien 895.00 #
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f Dated at Fort Pierce, Florida, this a~ ~ day of
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a ~ /
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- - (Signatu e)
~ County t orney
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~ 4~;5865 3
~ SWORN to and subscribed before me '?9 t"';~ 9'~s ~
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~ this ~ ~ day of 4~-~ , 19~ . . . • • ~
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= Notary Public tate of Florida at L ge
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~ My Commission Expires / -L~ ~y' , . ~ ~
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~ This ir?strument was pr~pared by :
~ LE1fIiT 1. Ai.AMS ' • • • . - O R t~(~A Q
z St. lutie Co,.niy, ti~1H~(il11SQt/J1 ~1IS,. lOUK VvZ ~~E V~
fort Pierce, tbridn
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