PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on January 18th are requested to complete this reply form by Tuesday, January 15th and mail it to:

Persons wishing to present testimony at the public hearing on February 7th are requested to complete this reply form by Tuesday, February 5th and mail it to:

Jennifer Best
Legislative Analyst
Assembly Committee on Aging
Room 522 - Capitol
Albany, New York 12248
Email: Bestj@assembly.state.ny.us
Phone: (518) 455-4371
Fax: (518) 455-4693


box I plan to attend the following public hearing on the Abuse and Exploitation of Vulnerable Elderly Citizens to be conducted by the Assembly Committees on Aging and Judiciary on Friday, January 18th.

box I plan to attend the following public hearing on the Abuse and Exploitation of Vulnerable Elderly Citizens to be conducted by the Assembly Committees on Aging and Judiciary on Thursday, February 7th.

box I plan to make a public statement at the hearing. My statement will be limited to 5 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 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:

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FAX TELEPHONE:

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