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~ t STATE OF ELORIDA
~ DEP??RT~IENT OF HEaLTH AND REHABILITATIVE SERVICES
nGUGLAS DIRON
~ . Lucie County
. , _~.c::erk ~tc~~ NOTICE of LIEN
~ _ ~y Client vwnber 09-45116-02
/j _ D tyClesk t,ien ~lumber 9-1055
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Pucsuant to the provisions of Section 402.33(8) (a?, Florida Statutes, notice is hereby given that there have been zss~ssed,
^ursuant to provisions uf said law, against Cairie BiCks
702 North 22nd Street
Ft. Pierce, Florida 34950
liab~lity for payment of fees to the Florida Department of Health and Rehabilitative Services, pursuant to tht provis~ons of ~?d
;aw. the sum of S 207.00 unpaid fees, which after demand for payment thereof remain unPaid, and that by virtue of the
:;,o~~e mentioned law the amount of said fee, constitutes a lien in favor of State of Florida Department of Health ~nd Rehabilitative
~~rvices upon any title or interest, whether legal or equitable, in any real property, chattels rcal, or penon~l property of said ~lient
~~r responsible party. Sectiotl 402. 33( 8)( b) , Florida Stdtutes.
Periods for wtuch fees have been assessed, and the amounts there~f, are as follows:
~ Desetrius Solo~on (client)
~ -
{ 1QonthlYear Fee Assessed Nonth/Ye~r Fee Asxsxd
P
~ .5~0 Jt~~ 23 P ~ :5
~ Juvenile Division
~020821 4H
~ Case #89-1178 ~ ' .
~ ~f'?±G_ .
~ August 1989 195 . 00 - ~ °
~
~
~
~ Plus Accn~ed interest
~ Recon3in Fees 12.00
Total S 207.00 ~
r n i s 19 t hdaY ot Ja n u a r~ . p. t q 9U STATE OF FTIJRIDA DEPAEt~3+iP OF FffAI~Z~i
~ ~ SSRVIC,F.S
Tris instrument prepared by;
` S hPLT'1 , P"d2'31 ~
~YkJO ~ ~'k'o~-~~a.
= Department of H9elth d Rehabilitative Services Autho~ized Otticial
~ 'tl Georgia Avenue - E,
~ ~est Pal~a Beach. FloriOa 33401-5298 ~
~ ~07; 837-5087 - SunCoei 252-5087 Note ~itlt'!~'~ Stat a~~g
y(~1.~, ~ ~ry Pubtic SlM~ M F{orlda
~ Sr~rn to and Subscr ibed betora ms this I~1 ~=4iay ot ;~A.O.. 19 ~ t~? GomrMssla~ ~xP~~
~ dttobM 2a. 1~3
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~ MRS Form 540. Mar S3 IObW~tai prw~ous ~Mtio~s) O A rr1
StOtk NumO~r S7L0-000-0840-1) ~00~~~~ P~u[+~~
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