PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on May 17, 2005 are requested to complete this reply form as soon as possible and return it to:

Charlotte Johnson
by
FAX @ (518) 426-6923
PHONE (518) 455-2770
EMAIL to larkin@senate.state.ny.us
or
Steve Bochnak
FAX@(518) 455-4128

ORAL TESTIMONY BY INVITATION ONLY


box I plan to attend the public hearing on the Future of Horse Racing in New York State to be conducted by the Senate and Assembly committees on racing.

box I wish to make a public statement at the hearing. My statement will be limited to ten minutes and I will answer any questions which may arise. I will provide 20 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 committees’ mailing list for notices and reports.

box I would like to be removed from the committees’ 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:
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