NYC 9/11 Public Portal Document
jun i» i4UA:u'ip 51666599j88 p.2 '
INDIVIDUAL VERIFICATION
STATE OF NEW YORK )
ss.:
COUNTY OF
The undersigned, being duly sworn, deposes and says, that 1 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 mv 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:^
Sworn to before me^is /
de<ofJk)iMe,20i4 1 -
Notary'Public
10
NYC-WTC_000159519
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