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N~•~..., 1020820
'~f STATE OE FI.ORIDA
i DEP~RT~tENT OF HEaLTH ,~ND REHABILITATIVE S£RVICES
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~r,. Ftp t_~_____ n~trc~s nncox ~NOT 1 C E of L 1 E N
I.LCie Cotu~ly Clicnt vumber 09-451 1 S-OZ
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- ,~y - - 9-1054
Lien ~umber
~ Depa y Clerk
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Pursuant to the provisions of Section 402.33(8) (a). Ftorida Statutes, notice is hereby given that there h~ve been assessed,
~ursu~nt to provisions of said law, against Susie Bi78IIt -
4806 Barcelona Avenue
Ft. Pierce, F.lorida 34946
fi~biliry for payment of fees to the Florida Department of Nealth and Rehabiliwtive Services, putsuant to the provis~ons uf iacJ
taw. the sum of S 117 .00 unpaid fees, which after demand for payment thereof remain unpaid, and that by virtue of the
,bove mentioned law !he amount of said fee, constitutes a lien in favor of Ssate oE Florida Departmrnt of Health and Rehabilitative
S~rvices upon any title or interest, whether legai ot equitable. in any real propetty, chattels rea1, or penonai property of said ~lient
~r respoasible parry. ~~eCtiocl 402. 33( 8)( b) , Florida Statutes.
Periods for which fees h~ve been assessed, and the amounts thereof. ate :~s follows:
Alvin C. Tu~blin (client)
~+tonth/Year Fee Assessed Nonth/Ye~r Fee Asxssed
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~ •90 ~ar, 3 P z~ ~
~ Juvenile Division 1020820
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Case #89-1321 ' ' ' `
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~ August 1989 105.00 ' ~ _ ~
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` ~ Plus Accnied interest
Recordin Fees 12.00
Total S 117.00 ~
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; T,, ; 5 19 t tbay ot J a n u a r y ~ A. D. t 9 90 STATE OF FT~RIDA DEPAFOli~i~lf OF E~AL7N
: A[~D RgiABII.I'I~TIIIE SERVIC~S
Tnis instrun+ent prepared by:
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j Sf12I'fl ~6~ ~dl~ ~JQ~~ali~#
= Depa~t~nent of Nealth 3 Rehebilicative Services Authorizsd Otticial
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~ ttt Georgia Avenue
~ west Paln~ Beach, Florida 33401-5298
»07;837-5087 - SunCoa~ 252-5087 Not y,.~ - Sta~E~~MCA
Npt~ry publk Stst~ ol Fbr~d~
Sxorn to and Subscribed bAtO~A ms this ~~oay ot ~ A.O.. 19~~ . ~ ~,~yCo~aonb~bn'~
~ ' Ociober 2~.
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~ StOCk NumO~~' 5710-000-0'340-11 800K
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