Garrity Warning Template

 

"My name is ___________________ and I am employed with the _________________ Police Department as a ___________________. I am assigned to the __________________ Division and my assigned duty hours are ______ hours until _______ hours.
 
On ________ at approximately ____________ hours, I was ordered to submit this statement by ____________________. I present this statement at his order as a condition of my employment. Since my refusal could result in a possible employment forfeiture, I therefore, have no alternative but abide by this order. It is my understanding that this statement will not and cannot be used against me in any succeeding proceedings except in accordance with the law. It is also my understanding that the Department is requiting this statement solely and exclusively for internal and administrative purposes, and this statement can only be released to other agencies in accordance with the law.

 

For any and all intentions, I hereby preserve my Constitutional rights to remain silent under the FIFTH and FOURTEENTH AMENDMENTS of the United States Constitution and all other rights established by the law. Further, I rely specifically upon the protection afforded me under the doctrines set forth in Garrity vs. New Jersey, 335 U.S. 493 (1967), and Sperack vs. Klein, 385 U.S. 511 (1956), should this statement be used for any purpose other than as expressed herein above.

 

Finally, from the information provided me to date, I have fully cooperated and have answered all issues presented to me to the best of my ability and  recollection. However, I reserve the right to supplement  and/or amend this statement should additional facts be brought to my attention through further investigation, subsequent reflection on the  matter, because of an honest defect in perception of the events, or the common shortcomings of human memory."