NYC 9/11 Public Portal Document
INDIVIDUAL VERtFICATtON
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 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, 1 believe them to be true.
DATED: June ^^^2014
SIGN HERE: X.
PRINT NAME HERE:,
ADEUNER.ORIO
NOTARY PUBLIC, State of New York
No. 01FL4737509
Quatifled in Queen
Sworn to before me this • Commtesfoneci until
day of June, 2014
/Notary Public
10
NYC-WTC_000159515
OCR can misread numbers and units. Confirm readings against the page image before using them.