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2. Please complete the form with your testimony for the below referenced case for the Public Hearing record.
4. Case Number/Description*
5. Public Hearing Date*
   Public Hearing Date
7. Will you also be providing in person testimony at the Public Hearing*
   -- Select One --YesNo
8. In Favor, Neutral or In Opposition*
   -- Select One --In FavorNeutralOpposition
10. Email*
11. Phone Number*
13. First Name*
14. Last Name*
16. Address1*
18. City*
19. State*
20. Zip*
22. Written Testimony*
24. By checking the "I agree" box below, you agree and acknowledge that submitting, that this testimony will be a public record and a part of the case file for the governing body. Any testimony submitted after the public hearing Will Not be considered by the governing body.
26. Electronic Signature Agreement*

    1. I Agree
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

* indicates a required field