Advisement of Constitutional Rights

Agency Name:

Case No.

Date

Time

Before we ask you any questions, you must understand your rights.

Officer read Do you understand this? Initials:

Waiver of Rights

I have read this statement of my rights and I understand what my rights are. I am willing to make a statement and answer questions. No promises or threats have been made to me and no pressure or coercion of any kind has been used against me.

Signature of Advised

Printed Name of Advised

Witness Signature

Printed Name of Witness Agency

Advising Officer Signature

Printed Name of Officer Agency

Date

Time

Juvenile Rights Form

Agency Name:

Case No.:

Date & Time:

Before we ask you any questions, you must understand your rights.

Officer read Initials:

Waiver

I have read the statement of my rights shown above. I understand what my rights are. I am willing to answer questions and make a statement. I do not want a lawyer present during this interview. I understand and know what I am doing. No promises or threats have been made to me and no pressure or coercion of any kind has been used against me to waive my rights listed above.

Signed (Juvenile)

Date & Time:

I have read and understand the statement of rights shown above and agree.

Signed (Parent/Guardian of Juvenile)

Date & Time:

Witness:

Witness Signature

Date & Time:

Waiver of Parental Right to Be Present at Interview

Date:

Case No.:

Place:

Time:

I am the to .

I, , understand that I have the right to be present, and the law presumes that I will be present, during any questioning of . However, I do not wish to be present during the interview of my child and I authorize the interview to be done without me being present. I understand that at any time during the interview I can change my mind and ask to be readmitted to the interview.

(Signature)

(Witness)

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Advisement of Constitutional Rights

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Waiver

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