PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on the Interstate Insurance Compact are requested to complete this reply form as soon as possible and mail it to:

Nichole Katz
Legislative Analyst
Assembly Committee on Insurance
Alfred E. Smith Bldg., 23rd Floor
80 So. Swan St.
Albany, New York 12248
E-mail: katzn@assembly.state.ny.us
Phone: (518) 455-4311
Fax: (518) 455-7095


box I plan to attend the following public hearing on the Interstate Insurance Compact to be conducted by the Assembly Committee on Insurance on May 8, 2008.

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.

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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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