An individual may request correction or amendment of any record pertaining to him or her in a system of records maintained by EPA by submitting a request in writing to the Freedom of Information Office, or via the Agency's Privacy Act Web site at http://www.epa.gov/privacy or by fax, (202) 566-1639. The following information must be provided:
(a) The name and signature of the individual making the request;
(b) The name of the system of records;
(c) A description of the information sought to be corrected or amended and the specific reasons for the correction or amendment; and
(d) Sufficient documentation of identity as described under § 16.4(b). (An individual who is unable to provide the identification under § 16.4(b) or is submitting a request on line, must provide a statement declaring his or her identity and stipulating that he or she understands it is a misdemeanor punishable by fine up to $5,000 to knowingly and willfully seek or obtain access to records about another individual under false pretenses).