WARNING FOR JUVENILES

Place: . Date: . Time Started . Youth's Name: . Address: . Birthdate: . Birthplace: . My name is . I am a: . Are you under the influence of any alcohol or drugs? Are you taking any type of medicine? . If yes, what kind of medicine and who is your Doctor? . What grade are you in? . Are you passing or failing? .

Can you read and do you understand the English Language? . I would like to talk to you about: The maximum penalty for this is: Before any questions are asked, I will advise you of your rights. They are:

1. You may have your parents present with you before any questions are asked.

2. You have the right to remain silent.

3. Anything you say can and will be used against you in a Court of Law.

4. You have the right to talk to a lawyer and have him present with you while you are being questioned.

5. If you cannot afford to hire a lawyer, one will be appointed to represent you before any questioning, if you wish.

6. You can decide at any time to exercise these rights and not answer any questions or make any statements. Do you understand each of these rights I have explained to you? Do you have any questions about any of these rights? Having these rights in mind, do you wish to talk to us now? .

Signed: Youth

Witness:

Witness: