- . ..-
f?Tarn'ingLocation: c- . 
1- You have the rigrzi: to remain Silent and refuse to answer
912513310125- SDEP 
{initials} .
2- 53-1?? thing you do or ea; may be used againsz: you a con-n1; of
1mm A 
(initials), - . .
170' :91 to 5* L/with an at'tomey before any gaestioning
- 1.3 {1have as: attorney pusen: during any now or 3.1:
46; . L.. - . 
(initials) - -. - 
d- If ,you cmnot ,affozd an attorney, one Jill be provided for you


without cost.
(initials)
5- If you decide to ens-yer questions and/or make a statement now
without, an; attorney present, you will still have the 'ri i: to
5150p a?swerjng at any time. -
(initials) 




 

1 I
I, I 0 45- 740621?? 'have mag ziy rights printed amt: 
tone by ?37015} - Ifully
that_,understanding by

 

and have had' them read
ts have ?rthezf indicated 
to? make- stem - ?31397. . .

_1mder5?band-msr r5.

i i'?ifi?a'li??g *there?fr- -- I am- willing.
answer questions. do not want an attorney at this time. I am not
under the influence of any medication, drug, or alcohol- I understand
8:14 know a?et I am doing. I have not been threatened' in any manner and

have not received any promises of any ?nature- Any eta-temezit/s I make
all? and voluntarily- 

 

 

 

 

 

 

 

will be made fra
Signature: . 2 ?7 Witnessed:
A A E-N 

 

 

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Page Now pages Date: DOB:
. .. Time: 55$: .
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