Form Cg-5810e - U.s. Coast Guard Ucmj And Miranda/tempia Rights Page 2

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[Suspect should initial each paragraph]
I understand that:
Suspect’s
Suspect’s Rights
Initials
1.
I have the right to remain silent. I do not have to answer questions or make any
__________
statement.
2.
Before I decide whether I want to answer questions or make a statement, I may
consult with a lawyer. If I decide to consult with a lawyer, the interviewer will stop
the questioning. I may consult with a military lawyer provided without cost to me,
__________
or a civilian lawyer obtained at no expense to the government, if the government
intends to continue questioning me. If I decide to consult with a lawyer, I have the
right to have an appointed military lawyer, a civilian lawyer obtained at no
expense to the government, or both, present during any further questioning.
3.
If I decide to answer questions or make a statement, anything I say may be used
as evidence against me in any court-martial, nonjudicial proceeding,
__________
administrative proceeding, or civilian court.
4.
Even if I decide to answer questions or make a statement, I may at any time stop
__________
answering questions, refuse to make any further statements, or request to consult
with a lawyer.
5.
I have carefully read the above. I understand my rights. Any questions I have
__________
asked concerning my rights have been answered to my satisfaction.
With full knowledge of my rights and the information contained on both pages of this form, I voluntarily make
the following elections:
a. I do not desire to consult a lawyer.
c. I desire to consult a lawyer.
b. I desire to make a statement and/or answer
d. I do not desire to make a statement or
any questions.
answer any questions.
________________________________
________________________________________
[Time and Date]
[Signature of Suspect]
________________________________________
[Signature of Witness]
Interview Instructions
1. If the suspect elects either block c. or d., stop questioning. Consult the servicing legal office before
reinitiating any further questioning of this suspect concerning these suspected offenses.
2. If the suspect elects both blocks a. and b., the interviewer may continue questioning.
3. Any written statements by the suspect should be prefaced with the following statement: “With full
understanding of my rights, I make the following statement freely, voluntarily, and without any promises or
threats made to me.” The statement should be signed and dated by the suspect and a witness.
CG-5810E (2/11)
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