NYC 9/11 Public Portal Document
INDIVIDUAL VERIFICATION
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, I believe them to be true.
DATED: June
Z 2014
SIGN HERE: -----
PRINT NAME HERE: 77^/ (Lh/lJpl jLofY)
Sworn to before me this
day of June, 2014
LISAMARIE CORTESE
NOTARY PUBLIC, STATE OF NEW YORK
QUALIFIED IN SUFFOLK; COUNTY
REG. #01006243830
MY COMM. EXP. JUNE 20. 2015
N^ztrary Public
10
NYC-WTC_000159530
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