NYC 9/11 Public Portal Document
INDIVIDUAL VERIFICATION
STATE OF NEW YORK )
) ss.:
COUNTY OF )
The undersigned, being du y 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 _19_, 2014
SIGN HERE: X.
PRINT N/,ME HERE: Co.i'0/be Co-a
Sworn to before me this
day of June, 2014
Notary Public
Notary^SKatTof^ ew York
No. 01PE&175776
Qualit..d in Queens County .
Commission Expires Oct 15,20_ -J
.0
NYC-WTC_000159525
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