PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on December 19th are requested to complete this reply form as soon as possible and mail it to:

Richard B. Ancowitz
Counsel
Assembly Committee on Judiciary
Room 508 - Capitol
Albany, New York 12248
Email: ancowir@assembly.state.ny.us
Phone: (518) 455-4313
Fax: (518) 455-4682


box I plan to attend the following public hearing on The 2005-6 Judiciary Budget to be conducted by the Assembly Committee on Judiciary on December 19, 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.

box 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.

box

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






NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

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FAX TELEPHONE:


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