Notice of Public Hearing - Congressional and State Legislative Redistricting

PUBLIC HEARING REPLY FORM

Persons wishing to present testimony at the public hearing on congressional and state legislative redistricting are requested to complete this reply form as soon as possible and mail or fax to:

The New York State Legislative Task Force
on Demographic Research & Reapportionment
250 Broadway, 21st Floor
New York, New York 10007-2563
Phone: (212) 618-1100
Fax: (212) 618-1135

I plan to attend the public hearing in:

____ Brooklyn on September 20, 2011

____ Manhattan on September 21, 2011

____ Staten Island on September 22, 2011

____ Long Island on October 5, 2011

I plan to make a public statement at the hearing. My statement will be limited to 5 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:

___________________________________________________________________________________

I do not plan to attend the hearing

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:

___________________________________________________________________