HomeMy WebLinkAbout1714 ~ ~
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: ~ STATE OF F[.ORlDA
s = DEPART~IENT OF HEALTH AND REH~B[LITAT[VE SERVICES
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F~~-,:~PR ~n~'Tt~'~Sr'~ONNOTICE of LIEN
t:~ - L,::;,;:' _..?y Client vwnber 09-45123-02
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lr~: 't'o:.. c Lien rumbtr 9-1060
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Pursuant to the provisions of Section 402.33(8) Florida Statutes, notice is hereby given that there have been assessed.
~ursuant to provisions uf said law, against Flora StBC~
507 North 21st Street
Ft. Pierce, Florida 34950
~ iiab~lity tor payment of fees to the Ftorida Department of Health and RehabilitatiYe Services, pursuant to the provisions of iail
i:?w, the sum of S 342 .00 unpaid fees, which after demand for paymen[ thereof remain unpaid, and that by virtuc of the
~bove mentioned taw the amount of said fee, cortstitutes a lien in favor of State of Ftorida Department of Heaith and Rehabilitative
S~rvices upon any title or interest, whether tegal or equitable, in any nal property, chattets real. or penonal propercy of said ~lient
~.>r responsible party. S@Ct10[1 402.33( 8)( b) , Florida Statutes.
Periods for which fees have been assessed, and the amounts thereof, are as foilows:
Levi Rah~ing (client)
~tonth/Year Fee Assessed !~tonth/Ye~r Fre Asxssed
Juoenile Division ~ i Zi 54 'G~~
Case #89-1307 FiLE C M~n R= ~.:~i~~:..
DOUGI 4S QIXUN : ~
Septesber 1989 330.00 S1. LUC~F '.`~JhT ~
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~ Plus Accrued interest
~ Recordin Fees 12.00
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t Total S 342.00 i
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; ~~is i9thday ot Janusr~ . ~.D. t9 90 STA1E OF F71JR1~A O~AE~~FNT OF t~AI.TH
AI~D ~YZt~.S
; "`iis instrument prepared by:
~ S hei-ri Capps, Paraleg~l Speciali.st ~s~~-1•~.•~~
; ~8~artment of H~alth a Rehabilitativ~ Services Authorized Otticial
k ;~t Georgia Avenue jd
s ~95t Paln~ Beach. Florida 13401-5298
k aG7/837-5087 - SunCo~ 252-9087 No - StapERffi e
~ . trptaryr PuW1:: Stat~ ol Fio~id~
~ ~ ~Ap Comm+talo~ ExP~~a
~ Srorn to and Subscribed betor• ~ this ~~day ot a.fY~A.D.. 19~~. a~~~ 1990
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~ HRS fo~rn'540. Ma ~.1 lObsol~ta pnmou~ ~ditia+il
s Stpck Numb~r' S7a0-000-0SIQ-11 B~Q~ ~ j
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