PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on the lack of accessible and affordable housing for people with disabilities across New York State are requested to complete this reply form as soon as possible and mail or fax it to:

Kimberly Hill, Director
Assembly Task Force on People with Disabilities
Agency Building 4, 13th Floor
Albany, New York 12248
Email: hillk@assembly.state.ny.us
Phone: (518) 455-4592
Fax: (518) 455-4731


box I plan to attend the following public hearing on the lack of accessible and affordable housing for people with disabilities across New York State to be conducted by the Assembly Task Force on People with Disabilities and the Assembly Committee on Housing on April 30, 2004.

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.

box 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 Task Force and Committee mailing lists for notices and reports.

box I would like to be removed from the Task Force and Committee mailing lists.

box

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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