Fiscal Note Request

* Indicates required fields

Requestor Information

Name*

Title*

Office*

Phone*

E-Mail*

Recipient E-Mail*

Legislation Number*
Example: LBD 00000-00-0 or Assembly / Senate bill numbers

Request Title*
Example: Increase benefit for certain members

Sponsors*
Example: Assembly Member / Senator

Description*
Example: To allow group to benefit...

Previous Fiscal Note, if applicable
Example: FN 20 xx-xx

Please do not submit Social Security Number or other personal identifying information.

Proposed Legislation* Choose a file…no file selected

Additional Data Choose a file…no file selected

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