HomeMy WebLinkAbout2083 44204
IN THE CIRCUIT COURT OF THE NINETEENTH
JUDICIAL CIRCUIT IN AND FOR
STS LUCIE COUNTY, FLORIDA
CASE NO: 783{CA
THEODORE GILCHRIST, )
Plaintiff, )
vs. _ )
JAMES HARRY and MARY ) l9T9 SAY 14 All ~ I S
HOWARD HARRY, )
i1lEt~A OppR~IEt~CDR~~EO
Defendants. ~ ) SROGE~EP~TRAS`A.
CLERK CIRCUIT I:OIRtt
RECORD NERIFIE['_
NOTICE OF LIEN 4,1~~04
AMERICAN HOME ASSURANCE COMPANY; a workmen's compensation
carrier for the employer of the plaintiff, THEODORE GILCHRIST,
pursuant to 440.39(3)(a) of the Florida Statutes, gives notice
that THEODORE GILCHRIST was in the course of his employment with the
employer, DIXON'S PHILLIPS 66, when he was injured at the time
and place alleged in the complaint filed in this cause, and
AMERICAN HOME ASSURANCE COMPArIY has paid to the plaintiff, THEODORE
GILCHRIST, and on behalf of the said plaintiff, various sums of
money for workmen's compensation and medical benefits and that it
is probable that future compensation and medical benefits under the
4
Florida Workmen's Compensation Act will be paid to the plaintiff.
WHEREFORE, AMERICAN HOME ASSURANCE COMPANY claims a lien
upon any recovery by the plaintiff for the full amount of benefits
~ previously paid to the plaintiff under the Florida Workmen's
Compensation Act as well as the full amount of benefits to be aid
P
in the future under the provisions of the act.
I HEREBY CERTIFY that a copy of the foregoing has been
furnished, by hand delivery, to VINCEP7T A. LLOYD,~ESQ., Attorney for
Plaintiff, P. O. Box 4382, Ft. Pierce, Florida 33450, this
day of May, 1979.
ADAMS, COOGLER, WATSON, & SMITH
Attorneys for American Home & Dixon's
322 First Street - P.O. Box 2069
West Palm Beach, Florida
659-7200
' \ r
n~o~.308 oA~~2U83 By ~
L. C. SHEPARD, R.
ADAMS, COOGLER, WATSON 6 SMITH, 322 FIRST STREET, WEST PALM BEACH, FLA. • TEL. 13051 659-7200
_ s ~ _ ~