A State or local agency may request a waiver under State Government Article, §7-308(d), Annotated Code of Maryland, from the requirements of the Program for specific individual participants. The waiver request shall be in writing on a form provided by the Secretary and contain: Identification of the statutory, regulatory, or administrative requirements that demonstrate the agency's bona fide purpose for the use of the actual address of a participant; Identification of the specific participant for which the waiver is requested; Identification of the individuals and agencies that will have access to the record; The name and telephone number of an individual to contact regarding the request; and An explanation of how the agency's acceptance of a substitute address will prevent the agency from meeting its obligations under the statute or regulation listed in §B(1) of this regulation. During review of the agency's request for a waiver, the agency shall use the participant's substitute address for any record that is the subject of the waiver request. Before granting a waiver, the Secretary shall: Notify the participant of the waiver request; and Inform the participant of the agency requesting the waiver and the reasons for the request.