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1020818
: STATE OE•FLORIDA
: DEP~RT~tENT OF HEALTH ~ND REHAB[LIT,~?T[VE SERVICES
~~~e = DaUGLAS DIRON N OT 1 C E of L 1 E N
t'er S' Lucie County Clicnt Vwnber 09-45113-02
' - - - Clerk ~f Circuit Co~!
~i ~ ~l - ~Y Lien ~iumber 9-1052
~ De ty Clerlc °
'1`ut~l 3 ~ ;
Pursuant ta the provisions uf Section 402.33(8) (a). Florida Statutes, notice is hereby given that there have been assrssed,
~ursuant to provisions uf said law, against Margaret Dsvis
810 Avenue B
Ft. Pierce, FLorida 34950
~~~zbility for payment ol fees to the Ftorida Department of Health and Rehabilitative Services, punudnt to che prov?sions ui ~iJ
law, the sum of S 417 .00 unpaid fees, which after demand for payment thereof remain unPaid, and that by virtue of the
~bove mentioned law the amount of said fee, constitutes a lien in favor of State of Florida DepartmCnt of Health snd Rehabilitative ~
~~rvices upon any title or interest, whether legal or equitable, in any real propecty, chattels real, or personal property of sa?d ~:ient '
~~r responsible party. SeCtiOt1 402.33( 8)( b) , Florida Statutes.
Periods for w!uch fees have been assessed, and the amounts thereof, are :~s follows:
Yelvin Davis (client)
ldonth/Year Fee Assessed Month/Ye~r Fec Asxssed
~
i ,7uvenile Division '~7 ,JAN 23 P2 ~`~1
Case #89-1197 i02081e
: ~ : ,
~ .~.r,`tr, i .
' August 1989 405.00 -
l ( :
i
! ~
~
~ .
~ ~ ,-r"
4 `
8
~ Plus Accrued interest
t
~ Recordin Fees 12.00 i
~ Total S 417.00 S ~
~ ~
~
T h~ s 19 t t~ay of Ja n u a r y , o. t 9 90 STATE C?F Fi~7RID~ D~P~1It~NT OF E~?L1Ii
~ - A[~D ~~ABILI'TATIVE 5~1TICES
~
~ ~his instrument prepared by:
~ ~ hern Capps ~ Para-le~l SpecialLSt 3
~ Det~artn+ent of Heelth 3 Rehabilitative Services Authorize Otticial
~ ~ti Georgia Avenus ~ p
~ rrest Pal~n Beech. Florida 33401-3298
~ ~s07;837-5087 - SunCo~ ?S2-S087 No - St ~ a
~ , Nou~? a~c s~,a a ~o~a.
~worn to and SubseribeC betors ms this 19thday ot ~A.D.. 19~~. ~.ye~~„~/l
- . OctoOa 2e. f~q
~ •
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~ Has Fo.n+ sao, rw. s3 ~oaa.e« w.wo~..e,c~on.? g~ 6'?4 PACE~O ,
Stotk Numo~r' 5740•000•OS~tO•11
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