NYC 9/11 Public Portal Document
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INDIVIDUAL VERIFICATION
STATE OF NEW YORK )
) ss,:
COUNTY OF )
The undersigned, being duly sworn, deposes and says, that I am a
cfaimant 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 7^2014
SIGN HERE: X , >
PRINT NAME HERE:
Sworn to before me this 7^
day of June, 2014
Notaiy^Ptf^c
NoteryVSSSte fffi York
- .No. 02FE4784757
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10
NYC-WTC_000159536
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