A. A person in interest may consent, or subsequently withdraw consent, to disclose personal information.
B. The consent or withdrawal of consent shall be in writing and mailed or delivered to the Administration's Official Custodian. The request shall include:
(1) Soundex or driver's license number;
(2) Full name;
(3) Date of birth;
(4) Signature; and
(5) A photocopy of the person in interest's last Maryland driver's license or identification card on record with the custodian.
C. The custodian shall maintain a record of a consent or withdrawal of consent of personal information.