PUBLIC HEARING REPLY FORM
Persons wishing to present testimony at the public hearing on examining the impact of the enacted SFY 2011-12 State Budget are requested to complete this reply form as soon as possible and mail, email or fax it to:
Laurie Barone
Senior Analyst
Assembly Committee on Election Law
Alfred E. Smith Bldg. Suite 1147
80 So. Swan Street
Albany, New York 12248
Email: baronel@assembly.state.ny.us
Phone: (518) 455-4313
Fax: (518) 455-3669
I plan to attend the following public hearing on Examining the impact of the enacted SFY 2011-12 State Budget to be conducted by the
Assembly Committee on Election Law and the Assembly Subcommittee on Election Day Operations and Voter Disenfranchisement on
December 1, 2011.
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.
I will address my remarks to the following subjects:
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I would like to be added to the Committee's mailing list for notices and reports.
I would like to be removed from the Committee's mailing list.
I will require assistance and/or handicapped accessibility information. Please specify the type of
assistance required:
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NAME:
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TITLE:
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ORGANIZATION:
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ADDRESS:
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E-MAIL:
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TELEPHONE:
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FAX TELEPHONE:
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