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NOTICE OF LIEN 44~856
STATE OF FLORIDA
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
Commissioners of St. Lucie County, Florida, claims a lien in the
amount of Five Hundred Thirty-seven and no/100's
537.00 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
. (Name of
Annie Ruth Moss Of 5~6 B So. 32nd St., Ft. Pierce, FL
Indigent or Recipient) (Addres~
for money directly spent by St. Lucie County for the care, hospital-
ization,~sustenance or maintenance of Alton Moss
son- Annie Ruth Moss •
of said
(Relationship)
as follows: ~
Hospital; Lawnwood Medical Center
Date Admitted: 3/31/79
Date Discharged; 4/3/79
Number of Days: 3 at $ 179.00 per day = $ 537.00
~ Less Credits none
i
~ Amount of Lien $ 537.00
j Dated at Fort Pierce, Florida, this ~s~ day af May ,
~ 19 ~g . ~
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~
~
~ (Sign ure
~ , ~
~ , - ' _ _ County Attorney
~ _ `r°_. _ . _ (Title)
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~ - i_ . i)~ .
? ~'~„~o.~.~ind subscribed before me ;
° ' ~9t9 ;t~~~ 18 ~r~ 31
f
; th i s d ay o f 9~. F LEO A 0 NE~qKoEo
~ S~ LUCI~CqtitlTY.fIA.
" C
ERK
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RCUtT C AS 41
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~ , yL, ~ RECORO ~'ERif tED____
~ Nota Public State of Flori~ at Large 444856
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~ My Commission Expires: c'~~
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~ This insin;mert was pr~pared !~y
~~~=~1,. R ~09 ~~E 69 :
.~,t. Lutie GG_niy, r.,,.~ 1.J.:i'C'iGl1 fl.J~. ~e~~ ;
~ Fort Pierce, tbrida
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