PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the joint public hearing on State Bridge Inspections and Evaluations are requested to complete this reply form as soon as possible and return it to:

Simonia Brown
Committee Assistant
Assembly Committee on Transportation
Room 513 - Capitol
Albany, New York 12248
Email: browns@assembly.state.ny.us
Phone: (518) 455-4881
Fax: (518) 455-4128


box I plan to attend the following joint public hearing on the State Bridge Inspections and Evaluations to be conducted by the Assembly Committee on Transportation on Monday, March 6, 2006.

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:

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