PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the joint public hearing on "The Death Penalty in New York" are requested to complete this reply form as soon as possible and mail, email or fax it to:

Seth H. Agata, Counsel
Assembly Committee on Codes
Room 508 - The Capitol
Albany, New York 12248
Email: agatas@assembly.state.ny.us
Phone: (518) 455-4313
Fax: (518) 455-4682


box I plan to attend the joint public hearing on "The Death Penalty in New York" to be conducted by the Assembly Committees on Codes, the Judiciary and Correction in New York City on December 15, 2004.

box I plan to attend the joint public hearing on "The Death Penalty in New York" to be conducted by the Assembly Committees on Codes, the Judiciary and Correction in Albany on January 25, 2005.

box I would like to make a public statement at the joint hearing in ____ NYC or ___ Albany. My statement will be limited to ten (10) minutes, and I will answer any questions which may arise. I will provide thirty (30) 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 either of the above hearings.

box I would like to be added to the Committees' mailing lists for notices and reports.

box I would like to be removed from the Committees' mailing lists.

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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:

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