If the Department or local department finally refuses a request to make a correction or amendment pursuant to Regulation .06, the person in interest may submit to the Department or local department a concise statement, not to exceed five 8-1/2 x 11 inch pages, of the reasons for: The requested correction or amendment; and Disagreement with the Department or local department's refusal to make the requested correction or amendment. The Department or local department which discloses to a third party information from a personal record about which a statement of disagreement has been filed, shall furnish a copy of the statement to the third party.