PUBLIC HEARING REPLY FORM

Persons invited to present testimony at the public hearing on Security Freeze to be held on November 21, 2005, or who wish to submit written testimony only, are requested to complete and return this reply form to:

Robert Caroppoli
Office of Senator Charles J. Fuschillo Jr.
30 South Ocean Avenue
Freeport, NY 11520
Phone: (516) 546-4100
Fax: (516) 546-4334 		Jeff O'Donnell
Assembly Committee on
Consumer Affairs and Protection
Room 513 - Capitol
Albany, New York 12248
Phone: (518) 455-4355
Fax: (518) 455-4128

box I plan to attend the public hearing on Security Freeze to be conducted by the Senate Committee on Consumer Protection and the Assembly Committee on Consumer Affairs and Protection on November 21, 2005.

box I have been invited to make a public statement at the hearing. My statement will be limited to 10 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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