PUBLIC HEARING REPLY FORM

Persons invited to present testimony at the public hearing are requested to complete this reply form by October 3, 2011 and mail it to:

Eric Jacobsen, Committee Assistant
22nd Floor
Alfred E. Smith Office Building
Albany, New York 12248
Phone: (518) 455-4355
Fax: (518) 455-7250
Email: jacobsene@assembly.state.ny.us
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I plan to attend the Governmental Operations and Oversight, Analysis, and Investigation public hearing on October 5, 2011
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I have been invited to make a public statement at the hearing. My statement will be limited to ten minutes, and I will answer any questions which may arise. I will provide 20 copies of my prepared statement.
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I will address my remarks to the following subjects:


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I do not plan to attend the above hearing.
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I would like to be added to the Committees' mailing list for notices and reports.
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I would like to be removed from the Committees' mailing list.
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I will require assistance and/or handicapped accessibility information. Please specify the type of assistance required:


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