NYC 9/11 Public Portal Document
JUIU1 i4uy:4tja LA VILLA HUWAKU BEACH 7186418505 P-l ‘
INDIVIDUAL VERIFICATION
STATE OF NEW YORK )
) ss.:
COUNTY OF ]
The undersigned, being duly sworn, deposes and says, that I am a
claimant In the within action, that 1 have read the foregoing NOTICE pF CLAIM
/NOTICE OF INTENTION TO MAKE CLAIM and know the contents thereof; that the
same is true to my own knowledge, except as to the matters therein alleged to
be on information and belief, and os to those matters, I believe them to be true.
DATED; JuaeJL. 2014
SIGN HERE; X
PRINT NAME HERE:.
Sworn to before me this
day of 2C14
Notary Public
FLORENCE RENNA .
Notary Public, State of New York
No. 01 RE 5032199
Qualified in Queens County, _
Commission Expires July 21v '2^0 it ,•
10
NYC-WTC_000159506
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