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NOTICE OF LIEN
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
alROUnt Of Three Thousand Fort three and no/100's
3,043.00 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Mary Lizzie Brockington Of:~Q04 Ave. R. Ft. Pierce, FL
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of Lillie Mae Carson
mother Mary Lizzie Brockington
of said
(Relationship)
as follows:
Hospital: Lawnwood Medical-Center
Date Admitted: 2/6/79
Date Discharged : ~~t3~~9
Number of Days: 17 at $ 179.00 per~day = $ 3,043.00
E
Less Credits none
f 3,043.00
~ Amount of Lien $ .
~ Dated at Fort Pierce, Florida, this day of Q'C~,
19Zd_.
a
(Sign tur )
COUNTY ORNEY
(Title) 4~~;~1
SWORN to and subscribed before me ~~79 OCT 12 ,u, Qs
FItEU RhU F<ECOnuF U
this day of ~C~w ~9 79 ~ Sf.LUCtECOUHTY.f'lA.
~ ROGER POITRAS
CLERK CIRCUIT CO'.SR~
~ Notary Public State of Flor da at Large'.i':.t.~
. _
My Commission Expires : / ' Z-~- ~ ~ ~ _ ;
_ _ _
This instrom~nt ~:as rre^crr! by ~ •
~ L~Vtit ; ,.i,:;,~,
St. Lucie Ca_n:y, s.~..,~,,.... _..,....1 j. B(}t~~~~V ~~E~~
fort Pir;rce, tbriaa