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:
______ Syracuse on July 19, 2011
______ Rochester on July 20, 2011
______ Syracuse on July 19, 2011
______ Rochester on July 20, 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 above hearing.
I will require assistance and/or handicapped accessibility information.
Please specify the type of assistance required:
NAME:
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