PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on the circumstances and conditions of domestic employment are requested to complete this reply form as soon as possible and mail, e-mail or fax it to:

Dallas Trombley
Legislative Analyst
Assembly Committee on Labor
23rd floor, Alfred E. Smith Office Building
Albany, New York 12248
E-mail: Trombld@assembly.state.ny.us
Phone: (518) 455-4311
Fax: (518) 455-7095


box I plan to attend the following public hearing on the circumstances and conditions of domestic employment to be conducted by the Assembly Committee on Labor on Friday, November 21st, 2008.

box I plan to make a public statement at the hearing. I will provide 10 copies of my prepared statement, and I will answer any questions which may arise.

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 mailing list for notices and reports.

box I would like to be removed from the Committee 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:

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FAX TELEPHONE:
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