PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on Fire Department services on Staten Island are requested to complete this reply form as soon as possible and mail it to:

Daniel Cooper
Graduate Scholar
Assembly Committee on Oversight, Analysis And Investigation
Agency 4, 12th Floor
Albany, New York 12248
Phone: (518) 455-3039
Fax: (518) 455-4175
cooperd@assembly.state.ny.us


box I plan to attend the following public hearing on Fire Department services on Staten Island, to be conducted by the Assembly Committee on Oversight, Analysis and Investigation and the Assembly Committee on Codes on May 13, 2005.

box I plan to make a public statement at the hearing. My statement will be limited to 10 of minutes, and I will answer any questions which may arise. I will provide 10 copies of my prepared statement at the hearing and will send a copy to the Committees by May 10, 2005.

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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:

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ADDRESS:

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