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: STATE OF FLORIDA
: DEP~RT`tEYT OF HE~LTH ,~~iD REHABtLiTATIVE SERVICES
' - Fce t D(3UGLAS DIRON
t~ s__ - S'. Lucie County N OT 1 C E of L 1 E N 09-45114-02
c"~':ix S l;ler:- ~f Ci:M.~it Coui! Client ~umber
~~,c ~ 3~~ , g-1053
Dgp Clerk Lien vumber s
'I'otal 3 _.1L~
Pursuant to the provisions of Section 402.33(8) (a), Elorida Ststutes, notice is hereby given that there have been zssessed,
~ursuant to provisions uf said law, against Gvendol~n Benjs~in
4807 San Biego A~enue
Ft. Pierce, F.lorida 34950
ii~bility for payment of fees to the Ftorida DeQartment of Health and Rehabilitative Services. pursuant to the provu~ons of i:ii~f
i~.~, the sum of S 207.00 unpaid fees, which after demand for payment thenof remain unpa~d, and that by virtue of the
,
;c~~ve mentioned law the amount of said fee, constitutes a lien in favor of State of Florida Departmcnt of Hralth snd Rehabiliwtive '
~~•rvices upon any title or interest, whether legal or equitable, in any real property, chattels real, or personal property of said ~lieret
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~~r responsible party. Sectlon 402.33( 8)( b) , FlOrida Statutes.
Periods for w!1ich fees have been assessed, and the amounts thereof, aro 3s follows:
Rodne {i. Ben'a¦in (client)
1~(onth/Year Fee Assessed HonthlYe~t Fre :~ssessed
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i ?uvenile Division '90 ~AN 23 P2:~1 1,
~ Case ~89-1322 1~2~8 ~ 9
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~ ~ Septe~ber 1989 195.00 S :V';
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~ Plus Accrued interest
Recordin Fees 12.00
Totai S 207.00 ~
~ 'r; ; s 19 t~ay ot Ja n ua r~ . o. t 9 9 ~ STATE OF F~DRII~A DEPA~I1f OF IiFALZH
AND E~3i~BILI'I'XrIVE S~tYI~SS ~
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~ "~is instrumertt prepared by:
~ 1~^+~ ~ ~ ~/F~,a~ ~
~ ~herri Capps, Parale~al Spec
Departaient of Health b Rehabilitative Services Authorized Oftic'
"t Georgia Avenu• F IA ~
dest Palm Beach, FloriCa 33401-5298
~07;837-5087 - SunCaa 292-5087 No r li ~
1r ~ Oc ~ ~ 19oC!
~rorn [o and Substribed bsfore ms this ~hday ot i~Clm"~A,D.. 19
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~ MRS Fwin 5W, M.. ~~o~?~.. ~~..~,t,~.~ soo~ 674 P~?~1201
Stotk NumO~r S7i0-000-08L0•1 )
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