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HomeMy WebLinkAbout1863 ~ 4t~~46'7 ~ / IN~THE CIRCUIT COURT IN AND FOR ST. LUCIE COUNTY, FLORIDA CASE NO: } LESTER LEE WILSON, - Plaintiff, . vs. RONALD DEAN RADNEY and PRIDGEN & SONS, It1C. Defendants. / 3 I~(OTICE OF PAYMENT OF COMPENSATION AND MEDICAL BENEFI'~S ' AND ~ CLAIM OF LIEN THEREFOR Tne FLORIDA FARM BUREAU INSURANCE COMPANY,_ worker's compensation carrier for the above-captioned Plaintiff, LESTER LEE WILSON, by and through its undersigned attorneys ~ and pursuant to §440.39(3),~Florida Statutes, hereby gives o ~ notice of payment of compensation and medical benefits paid ~ ~ N or to be paid to or on behalf of the Plaintiff under A ~ Chapter 440, Florida Statutes. _ a? o ~ w WHEREFORE, the FLORIDA FARM BUREAU INSURANCE COMPAi1Y ~ o o hereby affirms and asserts its lien upon any judgment or v ~d N~ settlement recovered by the Plaintiff in this case to the '~"M o extent that the Court may determine its pro-rata share of said judgment or settlement for compensation and medical .a _ w benefits paid or to be paid by the lien-claimant under the ~ provisions of Chapter 440, Florida Statut s. aai - a ! 1-1 i~~U n:~~: C HERB T G TON, J s1.t-t;~c~ t``~` Y•' ~ ` Driscoll Lan ston ~cc~<<, N~itn ,s - g Lay n & Kane , P . A . ~ Ear c'z~u~; ~K; 3222 Corrine Drive ~ ~ Orlando, Florida 32803 ~ ~ ~,3~6~ Attorney for Florida Farm Bureau Ins. Co. 305/894-8821 x STATE OF FLORIDA , COUNTY OF ORANGE Before me personally appeared HERBERT A. LAiJGSTON, J~~-, ~ who being first duly sworn, deposes and sayts hat he exe~t~t~~~-~`~,~ta,,~ foregoing as representative of Florida•'F Bureau l~`;~~..~o'~, . Sworn to and subscribed before s t - ~ ` ~ ~ _ - •~L~y 4 ) 1 ~ 1 .~Iy Commi ion , . ~.i 'alJOyb~..~`` t anrnc eX.~J P ~ ' ~ ~