PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on the Regulation of Social Security Numbers and Personal Identifying Information are requested to complete this reply form as soon as possible and mail it to:

Nichole Hedglin
Legislative Associate
Assembly Committee on Consumer Affairs and Protection
Assembly Committee on Governmental Operations
Room 513 - Capitol
Albany, New York 12248
Phone: (518) 455-4355
Fax: (518) 455-4128


box I plan to attend the following public hearing on the Regulation of Social Security Numbers and Personal Identifying Information to be conducted by the Assembly Committees on Consumer Affairs and Protection and Governmental Operations on September 15, 2005.

box I plan to make a public statement at the hearing. My statement will be limited to ten of minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement.

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I will address my remarks to the following subjects:



box I do not plan to attend the above hearing.

box I would like to be added to the Committee mailing list for notices and reports.

box I would like to be removed from the Committee mailing list.

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I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:




NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

TELEPHONE:

FAX TELEPHONE:
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