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$TATS,_ Of' .FLORIDA- _ - ,
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COSA~ITY OiF ST. LtJCIB _ -
• N0~1'ICS is hereby given that. pursuant tp the provisions of -
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Chapter 65=.181, Laws- of -Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Flgrida, claims a lien in the
-amount of One Thousand Seventy-lour and no/100's _
1^079._00 Dollars against any real or personal property ~ '
or interest therein presently held or after acquired by
Marie Jacksnp Of 2311 Delaware Ave., Ft. Pierce, FL
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(Indigent or Recipient) (Address) -
for money directly spent by 5t. Lucie County for the care, hospital-
ization, sustenance or maintenance of said :Indigent or Recipient
of welfare assistance, as follows:
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- Hospital: LavrnWOOd Medical Center - -
Date Admitted: 5/6/79
Date_Discharged: 5/12/79
Number of Days: at $ 179.00 per day = $ 1.07.4.00
none -
Less Credits
Amount of Lien $ 1,074.00
Dated at Fort Pierce, Flori this ~ day of
19~~.
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~5g-- -tore
- CO ATTORNEY
(Title)
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SWORN to and subscribed before me
/ - 459319
this ~ day of ~ lam/ , X3:9 7~,,.
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. ~;y i~,aJ,,~c ~ X19 SEP 18 Jlli ~ 34
Notary Public State of Florida a ~ r ~ ~ POtTRA
My Commission Expires : / ' ~1 _ ~ x. _ .vER~~ED
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THs irWrumeM wa: Prepared by -
DEViTT J. ADAMS - BIB `
St. Lucie County. Admmistraticn Bldg.
fort I'~erce, ~ lorido