NYC 9/11 Public Portal Document
XZ;XH UlNUtN K«KK • HAbt . Wi/Mi
INDIVIDUAL VERIFICATION
STATE OF NEW YORK }
) ss,:
COUNTY OF )
Th© undersigned, being duly sworn, deposes and says, that I am a
claimant In the within action, that I have read the foregoing NOTICE OF 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 as to those matters, i believe them to be true.
DATED: June ,^,2014
SIGN HERE: X
PRINT NAME HERE:.
Sworn to before me this
day of June, 2014
' .
I YUCHAI LONG
, Notary Public - Sials of New York
, NO. 01106235183
Qualified in Queens Cou{
itary Publi6'’ ’ My Commission Expires
10
NYC-WTC_000159510
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