Request Form

After filling out the web form below, you will be prompted, on the next page, to enter a randomly generated word. This is done to cut down on the amount of spam that is sent to our office. Incredibly, computer “bots” scour the web searching for pages like our Request Form to automatically inject spam or malicious code into. Apologies for any inconvenience.

Your Name:
Your e-Mail:
Mailing Address:
City:
State:
Zip:
County:
Phone:
Your Comments:

New York State
Defenders Association
194 Washington Ave,
Suite 500
Albany, NY 12210
(518) 465-3524
FAX: 465-3249

Updated:
Thursday, 1/11

PLEASE NOTE:
In lieu of asking you to type in your email address twice as many form request pages do, we ask that you check your email address carefully before submitting it. Although the form will be checked for proper email formatting when you “Click to Send” it, obviously if the email is entered incorrectly, we may have no way to get back in touch with you.

Thank you.


* Please note that Public defense lawyers and members of the public who need information or assistance may contact the Backup Center by phone at (518) 465-3524 or through our online Request Form.

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