Finding the Facts - Disciplinary and Harassment Investigation

12. If subject waives Constitutional rights, then go to 14; if subject does not waive constitutional rights then go to 13.

13. Although you have refused to waive your Constitutional rights, be advised that I will now proceed with the administrative aspect of this interrogation. Therefore, you are now ordered to fully and truthfully answer all questions asked of you during this interrogation. Your failure to do so will, in and of itself, constitute a disciplinable act of insubordination and will result in a recommendation of disciplinary action against you, up to and including dismissal. [District/Department General Order No.____ provides that: (include general order providing that insubordination is grounds for discipline). Statements made by you in response to this order cannot be used against you in a criminal proceeding.] 14. The nature of the interrogation focuses on administrative matters likely to result in punitive action and at your request, you have the right to be represented during the interrogation by a representative of your choice who may be present at all times during the interrogation. The representative shall not be a person subject to this investigation and shall not be required to disclose, nor be subject to any punitive action for refusing to disclose, any information received from you to the extent it does not regard criminal matters. The District/Department will neither provide nor compensate any such representative. 15. (Either:) (1) Do you have a representative present (if so, please identify him/her); or (2) Do you desire a representative (if one is not present, a reasonable recess will be appropriate in order to allow a representative to be secured); or (3) Do you waive your right to a representative (if so, have subject date and initial this line) . 16. The press or media may request your home address or photograph. Such information will not be provided without your consent. Do you consent to the release of such information? I consent (initial) ; I do not consent (initial) . 17. Prior to proceeding with the interrogation, do you have any questions regarding the admonitions that I have read to you (if so, respond to those questions which are appropriate)? 18. This interrogation admonition was read to me on _______________, 20__ at ___________ hours and by my signature herein, I acknowledge my understanding of my rights and duties.

Date _____________________

Signature _____________________

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