PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on The New York Health Benefit Exchange and its Impact on Immigrants and their Families are requested to complete this reply form as soon as possible and mail, email or fax it to:

Estibaliz Alonso
Senior Legislative Analyst
Assembly Program and Counsel
Room 442 - Capitol
Albany, New York 12248
Email: alonsoe@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693
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I plan to attend the public hearing on "The New York Health Benefit Exchange and its Impact on Immigrants and their Families" to be conducted by the Assembly Committees on Health and Insurance and the Task Force on New Americans on September 17th.
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I plan 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:



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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 Committee mailing list for notices and reports.
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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:


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