N.Y. Comp. Codes R. & Regs. tit. 9, § 525.15
(a) Claimant records are:
(2) confidential, subject to the provisions of section 633 of the Executive Law and section 96 of the Public Officers Law. Pursuant to section 633 of the Executive Law, the following exceptions exist to such confidentiality:
(b) A claimant shall notify the office of any change of contact information in person, by mail, or electronically via facsimile, electronic mail or any other manner the office may make available for the change of contact information pursuant to subdivision one of section 305 of the New York State Technology Law.
(1) If mailed, such notification shall be directed to:
Office of Victim Services
Alfred E. Smith State Office Building
80 South Swan Street, 2nd Floor
Albany, NY 12210-8002
(e) A claimant may authorize another party, who is not an authorized representative pursuant to section 525.3(c) of this Part, to receive information related to their claim. Such authorized party may request a copy of part or all of the claimant’s record by letter, indicating the claim number and containing an original signature of the authorized party and directed to the unit and address contained in subdivision (c) of this section. This authorization shall be valid unless and until revoked by the claimant in writing. A claimant who wishes to designate another party to receive information related to their claim shall provide to the office a notarized authorization compliant with Public Officers Law, section 96 before any confidential records of, or information about a claimant can be disclosed by the office. The form shall be as follows:
Authorization by Claimant for Release of Records
Pursuant to New York State Executive Law, § 633 and Public Officers Law § 96, I:
_______________ Name of Claimant (Please print)
_______________ Claim Number
hereby authorize:
_______________ Name of Individual
_______________
_______________
_______________ Address of Individual
_______________ Phone Number of Individual
to have a complete copy of the records maintained with respect to me and the above mentioned claim for their information. This authorization is to allow the Office of Victim Services to share the records compiled for this claim with the above authorized individual. This authorization shall be valid until revoked by me in writing.
_______________ Signature of Claimant
_______________ Date
| State of New York | )) ss.: |
| County of | |
| __________ | ) |
On the __ day of __ in the year __ before me, the undersigned, personally appeared _____, personally known to me or proved to me on the basis of satisfactory evidence to be the individual whose name is subscribed to the within instrument and acknowledged to me that he/she executed the same in his/her capacity, and that by his/her signature on the instrument, the individual, or the person upon behalf of which the individual acted, executed the instrument.
_______________ NOTARY PUBLIC
(f) The office may deny access to portions of a claimant record:
(2) to protect any personally identifying information from disclosure.
(g) Fees.
Fees for copies of claimant records may be charged, provided that: