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NOTICE OF LIEN •
STATE OF FLORIDA ,
COUNTY OF ST. LUCIE
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NOTICE is hereby given that pursuant to the provisions of •
Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County -
Commissioners of St. Lucie County, Florida, claims a lien in the
smount of Two Thousand One Hundred Forty-eiqht and no/100's
2,148.00 ) Dollars against any real or personal property
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or interest therein presently held or after acquired by
.Tamt~s Rc~hi con__ ~f _1808 Ave. L. Ft. Pierce. FL
(Indigent or Recipient). (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indigent or Recipient
of welfare assistance, as follows:
Hospital: Lawnwood Medical Center _ ~
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Date Admitted: 9/15/78 i
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Date Discharged: l0/6/78
Number of Days: 12 at $ 179.0o Per day = $ 2.14s.oo
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Less Credits none ~
~ Amount of Lien $ 2.148.00 -
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~ Dated at Fort Pierce, Florida, this day of
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~ l . 19~.
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~ (Signat re) ' ~
~ County Attorn y~
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a ~1'ltlf!, G!`"!' i.'1 i~tC~R~GOI
~ ~ : ~ ~ ~ ~ Y. Fta.
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~ SWORN to and subscribed before me • •
j 79 t~~ r 2 Q~! 9• 06
this ~ day of , 19~. I'~
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= Notary Public State of Florida La~ge;''~ ,
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~ My Commission Expires: /-~-~-~lZ ~ , - - .
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~ Tha instnimenf was preparod by ~ " ' • . .
5 GE1/1TT J. AGAMS ~~C ~4 Q~E V~
St. lucie Co..nry, Ad~s:;,.i,trai;on Bidr~. ' ~ K
` Fort Pierce, ~lorida
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