PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at this public hearing are requested to complete this reply form as soon as possible and mail it to:

Dominique Tauzin, Counsel
Assembly Committee on Codes
Room 508 Capitol
Albany, New York 12248
E-Mail:tauzind@assembly.state.ny.us
Tel:(518) 455-4313
Fax:(518) 455-4128


box I plan to attend the public hearing to be jointly conducted by the Assembly Committee on Codes, Correction and Mental Health on September 20, 2005.

box I would like 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:

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