PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing evaluating current housing programs are requested to complete this reply form as soon as possible and mail, e-mail or fax it to:

Zach Shapiro
Committee Assistant
Assembly Committee on Housing
Alfred E. Smith Bldg., 22nd Floor
Albany, New York 12248
E-mail: shapiroz@assembly.state.ny.us
Phone: (518) 455-4355
Fax: (518) 455-7250
box
I plan to attend the following public hearing evaluating current housing programs to be conducted by the Assembly Committee on Housing on December 14, 2009.
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: