PUBLIC HEARING REPLY FORM

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

Teresa Glanowski
Community Relations Director
936 Delaware Avenue, Suite 005
Buffalo, New York 14209
Phone: (716) 885-9630
Fax: (716) 885-9636


box I plan to attend the following public hearing on Lottery Payouts to be conducted by the Assembly Committee on Racing and Wagering on September 4, 2008.

box 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:



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.

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




NAME:

TITLE:

ORGANIZATION:

ADDRESS:

E-MAIL:

TELEPHONE:

FAX TELEPHONE:
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