N.Y. Comp. Codes R. & Regs. tit. 21, § 2053.12 – Statement of disagreement by data subject.

(a) If correction or amendment of a record or personal information is denied in whole or in part upon appeal, the corporation shall inform the data subject of his or her right to:
1. (1) file with the corporation a statement of reasonable length setting forth the data subject's reasons for disagreement with the determination; and
2. (2) request that such a statement of disagreement be provided to any person or governmental unit to which the record has been or is disclosed pursuant to section 2053.4(a)(4), (9) and (12) of this Part.
(b) Upon receipt of a statement of disagreement by a data subject, the corporation shall:
1. (1) clearly note any portions of the record that are disputed; and
2. (2) attach the data subject's statement as part of the record.
(c) When providing a data subject's statement of disagreement to a person or governmental unit in conjunction with a disclosure made pursuant to section 2053.4(a)(4), (9) or (12) of this Part, the corporation may also include a concise statement of its reasons for not making the requested amendment or correction.