A JUVENILE SITTING AS A JUVENILE COURT MAGISTRATES JUVENILE WARNING

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IN THE INTEREST OF: TH IN THE 90 JUDICIAL DISTRICT COURT IN AND FOR STEPHENS COUNTY, TEXAS A JUVENILE SITTING AS A JUVENILE COURT MAGISTRATES JUVENILE WARNING On the day of, 201, at o clock m., before me, the undersigned official acting as and in the capacity of a Magistrate, personally appeared _, a child, at, Stephens County, Texas. THE FOLLOWING RIGHTS AND WARNINGS WERE READ AND EXPLAINED TO THE CHILD: You are charged by law enforcement with the offense of, a misdemeanor / felony. 1. 2. 3. 4. 5. You may remain silent and not make any statement at all, and any statement that you make may be used in evidence against you; You have the right to have an attorney present to advise you either prior to any questioning or during any questioning; If you are unable to employ an attorney, you have the right to have an attorney appointed to counsel with you before or during any interviews with peace officers or attorneys representing the state; You have the right to terminate the interview at any time; Any prior oral statements made by you are NOT admissible except if the statement contains assertions of facts or circumstances that are found to be true, and which tends to establish your guilt. I have listened carefully to and understood each of the above rights as they were read and explained to me. I have asked the magistrate any questions that I may have regarding these rights. At this time, I fully understand all my rights as they have been explained to me, and I voluntarily wish to waive them. Answer YES or NO Date signed Time Signed MAGISTRATE S CERTIFICATE On this day before me, personally appeared, age, a juvenile. I certify that the foregoing statutory rights were read and explained to said juvenile, at, Stephens County, Texas. Stephens County, Texas

IN THE INTEREST OF: TH IN THE 90 JUDICIAL DISTRICT COURT IN AND FOR STEPHENS COUNTY, TEXAS A JUVENILE SITTING AS A JUVENILE COURT JUVENILE STATEMENT FORM My name is, and I am years of age. I live at, in County, Texas. I have years of education and do read, write and understand the English language. I have been warned of my juvenile rights, pursuant to Sections 51.09 and 51.095, Texas Family Code, by Magistrate Judge Stanley H. Peavy, III, in Stephens County, Texas at o clock.m., on the day of, 201. I UNDERSTAND MY RIGHTS AS THEY HAVE BEEN EXPLAINED TO ME AND I DO HEREBY FREELY KNOWINGLY AND VOLUNTARILY, WITHOUT BEING INDUCED BY ANY COMPULSION, THREAT, PROMISES OR PERSUASION, MAKE THE FOLLOWING STATEMENTS IN WRITING: Date Signed: Date Signed:

JUVENILE STATEMENT (continued) Date Signed: Date Signed:

JUVENILE STATEMENT (continued) Date Signed: Date Signed:

JUVENILE STATEMENT (continued) Date Signed: Date Signed:

JUVENILE STATEMENT (continued) _ End of Statement I fully understand the nature and contents of this statement and I do hereby sign it knowingly and voluntarily in the presence of the undersigned Magistrate. My statement contains pages. Date signed: Date signed:

IN THE INTEREST OF: TH IN THE 90 JUDICIAL DISTRICT COURT IN AND FOR STEPHENS COUNTY, TEXAS A JUVENILE SITTING AS A JUVENILE COURT MAGISTRATE S JUVENILE VERIFICATION I HEREBY CERTIFY AND VERIFY that I, Judge, acting as and in the capacity of a Magistrate, did on the day of, 201, at o clock.m., administer the juvenile warnings required by Sections 51.09 and 51.095, Texas Family Code to: Name:, a juvenile. Age: Date of Birth: Address: Who appeared before me in Stephens County, Texas. I FURTHER HEREBY CERTIFY AND VERIFY that I have examined the said juvenile above independent of any law enforcement officer or prosecuting attorney, except as required to ensure the personal safety of the magistrate or other court personnel, in accordance with the law. During the examination, I was advised by the said juvenile that he / she: 1. claims to be years of age; 2. can read the language, and has demonstrated to me that he / she can do so; 3. claims to be a citizen of ; 4. has completed the grade in school, and is now in the grade in school; 5. was not coerced, threatened or promised anything by law enforcement officers, prosecutors or any other agent of the State of Texas; 6. is not under the influence of drugs, alcohol, intoxicating beverages or inhalants; 7. has not been physically or emotionally abused by law enforcement officers, or anyone else; 8. has no other physical or medical conditions that might impair his / her ability to understand the rights read to him / her;

9. understands the meaning of the warnings given herein and has no questions about the warnings, except as may be noted as follows, if any: 10. understands that the offense charged is, and that this offense is a misdemeanor / felony; 11. understands what the statement says, and agrees that the statement is his / her version of the facts surrounding the said offense, and that it is true; 12. made such statement knowingly and voluntarily and of his / her own free will without any improper inducements or prohibited conduct by any law enforcement officers, prosecutors or any other person; and 13. has not been deprived of food, drink or sleep. The juvenile named herein was brought before me on this date by the following law enforcement officer: Name of officer: Employed by :. The juvenile also appeared before me accompanied by the following person(s): Parent, Guardian, or Custodian: Name of Person Attorney: Name of Attorney Other: Name of Person The following are additional observations that I have made during the course of interviewing the said juvenile, if any:.

Based upon the foregoing information and observations, I hereby verify and certify that I Am fully convinced that the said juvenile has knowingly, intelligently and voluntarily waived the attached statutory rights before and during the making of the statement which is attached hereby and made a part of hereof for all purposes. I am further fully convinced that the said juvenile understands the nature and contents of the statement, and that the said statement was voluntarily signed by the said juvenile in my presence on the following date and at the following time: The day of, 201, at o clock.m. Stephens County, Texas