HomeMy WebLinkAbout0699 . .
NOTICE OF LIEN ~ ~
~ 4~4~
STATE OF FLORIDA ~
COUNTY OF ST. I,UCIE ~
NOTICE ia hereby given that pursuant to the provisions of
Chapter 65-2181, Laws.of Florida, Acts of 1965, the Board of County
Com~nisBioners of St. Lucie County. Florida, claims a lien in_the
eimOUnt of Three Hundred Fifty--eiqht and no/100s
~ 358.00- ) Dollars against any real or personal property or
interest therein presently held or after acquired by
, (Name of
Kim Smith pf Rt 5, Box 756, Ft. Pierce. FL
Indigent or Recipient) (Address) ~
for money directly spent by St. Lucie Coun ty for the care, hospital-
ization, sustenance or maintenance of sric smith .
son of said Kim Smith
(Relationship) .
as follaws: ~
Hospital: Lawnwood Medical Center
Date Admitted: 10/14/78 .
Date Discharged: Zo/16/78
Number of Days: 2 at $179.00 per day = $ 358.00
f Less Ctedits none
i
I
~
` ~ Amount of Lien $ 358.00 -
~ - Dated at Fort Pierce, Florida, this day of ~ ,
19 79 .
~ -
:919 ~t!' "9 P~`' 1= 27 ~
ft~E +?KO kECjOY~ii~~~ (S ign ture
ST L~tE ~~?RA~ ~
CIERK
~I~Ott COUitT ~
COUNTY A TO IV~EY
prc+~p vFa~f~~a_-------`'" (Ti tle )
~ 45064'~
~
~ SWORN to and subscribed before me - ~
~ .
~ thie day of _ ~J CJ~ , ~9,vc
~ -
i
~ . ~ -
~ . ~
-:i .
Not~ Public State of Florida t Large
s ~
J ~ ~ ~ . '
~J , ' "
My Commission Expires: t,~ - . -
J - , , ` _
_P ~ ~
~?R 697 ~ .
~ " BOOK~~~ PA6E - '
~ .
- - - - -
a~~:mw: , . . _ ~:.~-~~a ~