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NOTICE OF LIEN 4~~'.
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 Three Thousand Five Hundred Thirty-six and 85/100's
3,536.85 ) Dollars against any real or personal property
or interest therein presently held or after acquired by
James L. Moore pf 413 No. 9th St., Ft. Pierce FL
(Indigent or Recipient) - (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or maintenance of said Indigent or Recipient .
of welfare assistance, as follows:
Hospital: Lawnwood Medical Center
Date Admitted: 10/6/79
Date Discharged: 11/2/79
Number of Days: 17 at $208.05 per day = $ 3,536.85
Less Credits none
I
~ Amount of Lien $ 3,536.85
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Da/ted at Fort Pierce, Florida, this v~ 7'/'~ day of
-C1-m 19
7~c
E
(Signatur
COUNTY ATTORNEY t
(Title)
SWORN to and subscribed before me
4'78'71
this ~ 7 day of ~ 19 79 .
- i919 SEC 28 X11 ii= 18
~
~ s . ~ FIIE~ ND ~ D
Notary Public State o Florida at itg~ ~ " ~ - ~Pa~A.
~ ' ' ' rr ~ p.ERK CIRCUR tAUR
My Commission Expires ~-a~-~~~ ,v- _ - ~vERIFIEO
-
t_ ~ .
This instnxnent was re or ~ ' ~ ~ , . s'
P A ed by _ _
i.EV1iT J. ~Gl.MS ~ nR~~ csrc//114
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