PUBLIC HEARING REPLY FORM
Persons interested in presenting testimony at the public hearing on The State of Senior Programs in the Current Economy to be held on October 5, 2009, or who wish to submit written testimony only, are requested to complete and return this reply form to:
Eric Jacobsen
Assembly Committee on Aging
Alfred E. Smith Office Building
80 South Swan St., Floor 22
Albany, New York 12248
Phone: (518) 455-4355
Fax: (518) 455-7250
I plan to attend the public hearing on The State of Senior Programs in the Current Economy
to be conducted by the Assembly Committee on Aging on October 5, 2009.
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.
I will address my remarks to the following subjects:
I do not plan to attend the above hearing.
I would like to be added to the Committee's mailing list for notices and reports.
I would like to be removed from the Committee's mailing list.
I will require assistance and/or handicapped accessibility information.
Please specify the type of assistance required:
NAME:
TITLE:
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