PUBLIC HEARING REPLY FORM

Persons invited to participate at the public hearing on the MTA's 2015-2019 Capital Program: Evaluating Transit Priorities for Brooklyn, Queens, and Staten Island are requested to complete this reply form as soon as possible and mail or fax it to:

Robert Franchini
Legislative Analyst
Assembly Committee on Corporations, Authorities and Commissions
NYS State Capitol Building
Room 513
Albany, New York 12224
Phone: (518) 455-4881
Fax: (518) 455-7250
box
I plan to attend the public hearing on the MTA's 2015-2019 Capital Program: Evaluating Transit Priorities for Brooklyn, Queens, and Staten Island to be held by the Assembly Standing Committee on Corporations, Authorities and Commissions.
box
I have been invited to make a public statement at the hearing. I will answer any questions that may arise. I will provide 10 copies of my prepared statement if I have one.
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: