STATEMENT OF OWNER SUPPORT

Before an individual nomination proposal will be reviewed or nominated, the owner(s) of

record must sign and date the following statement.

I,                             Alan Gerry  /  Gerry Foundation Inc.                            am the

                 (print or type owner name)

owner of the property at:

NY State Route 17B,  Hurd Road, West Shore Road, Bethel, Sullivan County, New York 

                     (street number and name, city, village, or town, state of nominated property)

I support its consideration and inclusion in the State and National Registers of Historic Places.                                                                                                                                    

    ___________________________________________________

      (signature and date)  

    ___________________________________________________

     ___________________________________________________

        (mailing address) 

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