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 2014
SIGN HERE: X ______
PRINT NAME HERE:
Sworn to before me this
day of 2014
Nc^ary Public (
JAMES A. LESSLIE //
Mertarv Public, ^ate of NswJnHk / /
No. 4^4613593
Qualified in Queana
9eimw«on Expires March 80, /r
10
NYC-WTC_000159570
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