PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on oversight of the alcoholic beverage industry are requested to complete this reply form as soon as possible and mail it to:

Benita Leigh-Lewis
Principal Committee Assistant
Assembly Committee on Economic Development,
Job Creation, Commerce and Industry
Room 520 - Capitol
Albany, New York 12248
Email: Leighlb@assembly.state.ny.us
Phone: (518) 455-4928
Fax: (518) 455-5182


box I plan to attend the following public hearing on oversight of the alcoholic beverage industry to be conducted by the Assembly Committee on Economic Development, Job Creation, Commerce and Industry on September 20th, 2005.

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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