NYC 9/11 Public Portal Document
INDIVIDUALVERIFICATION
STATE OF NEW YORK )
ss.:
COUNTY OF hlUSS/Uit {
The 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:
PRINT NAME HERe6^ f
Sworn to before me this
day of June, 2014
lotary Publj6
X
WffiICIAA.CnAWFC»D
NOTARY PUBUC
STATE OF NEW YORK
NO.01CR4985560
QUAUFIED IN NASSAU COUNTY^
COMMISSION EXPIRES 08/19/20X2
10
NYC-WTC_000159512
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