PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing are requested to complete this reply form as soon as possible and mail, e-mail or fax it to:

Gerard Savage
Committee Counsel
Senate Committee on Crime Victims, Crime and Correction
Legislative Office Building - Room 612
Albany, NY 12247
E-mail: gsavage@senate.state.ny.us
Phone: (518) 455-2061
Fax: (518) 426-6998

and

Amy Maggs
Counsel
Assembly Committee on Judiciary
Alfred E. Smith Building - Suite 1147
Albany, NY 12248
E-mail: maggsa@assembly.state.ny.us
Phone: (518) 455-4313
Fax: (518) 455-3669

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I plan to attend the public hearing on the IOLA and Civil Legal Services funding on Thursday, January 7, 2010 in Albany, NY, 11:00 A.M. - 6:00 P.M.
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I request to make a public statement at the hearing. My statement will be limited 10 minutes and I will answer any questions which may arise. I will provide 20 copies of my prepared statement and CD containing the same information. Selected speakers will be notified before the public hearing.
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I will address my remarks to the following subjects:


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


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I wish to have the attached written statement made part of the record.
NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

TELEPHONE:

FAX TELEPHONE: