PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on the Neighborhood and Rural Preservation Programs are requested to complete this reply form as soon as possible and mail, email or fax it to:

Anthony Kergaravat
Analyst
Assembly Committee on Housing
Alfred E. Smith Bldg., 22nd Floor
Albany, New York 12248
Email: kergara@assembly.state.ny.us
Phone: (518) 455-4355
Fax: (518) 455-7250
box
I plan to attend the following public hearing on the Neighborhood and Rural Preservation Programs to be conducted by the Assembly Committee on Housing on March 1, 2011.
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 Committee's mailing list for notices and reports.
box
I would like to be removed from the Committee's mailing list.
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: