PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on October 20, 2006 are requested to complete this reply form as soon as possible and mail it to:

Renee Skorupski
Committee Assistant
Assembly Committee on Insurance
Room 520 - Capitol
Albany, New York 12248
Email: skorupr@assembly.state.ny.us
Phone: (518) 455-4928
Fax: (518) 455-5182


box I plan to attend the following public hearing on Guarding Against Inequities in the Residential Insurance Market and Insurance Company Investments in Underserved Areas of New York State to be conducted on October 20, 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:

E-MAIL:

TELEPHONE:

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