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I acknowledge that I have received a copy of this Rights Advisory and Waiver:

Signed: _________________________________________ Date: _______

II.

Waiver of Rights (check one)

___

Youth is 16 years or older and voluntarily waived the rights identified in section I (complete section

IV).

___

Youth is 16 years or older and refused to waive the rights identified in section I (no questioning may

occur without counsel).

___

Youth is under age 16 and, after consultation with parent(s) or guardian(s), voluntarily waived the

rights identified in section I (complete section V).

___

Youth is under age 16 and, after consultation with parent(s) or guardian(s), refused to waive the right

identified in section I (no questioning may occur without counsel).

III.

Notification Requirements: Irrespective of age, the youth’s parents, guardian or legal custodian must

be notified immediately that the youth is in custody, and the location of and reasons for the custody.

Contact Information: ________________________________________________________________

Date/Time of Notification: ___________________________________________________________

_________________________________________________________________________________

(If you are unable to contact a youth’s parents or guardians, document each attempt)

IV.

Waiver of Rights for Youths Age 16 or Older:

I have been advised of my right against self-incrimination, the right to counsel, and the right to

parental notification. I understand those rights and voluntarily agree to waive those rights. I

understand that my waiver of those rights means law enforcement can question me without the

presence of counsel and without my parents or guardian present.

Signed: _________________________________________ Date: _______

Waiver of Rights for Youths Under Age 16

I have been advised of my right against self-incrimination, the right to counsel, and the right to

parental notification. I have discussed these rights with my parent(s) or guardian(s) and we

voluntarily agree to waive those rights. We understand that waiver of these rights means that law

enforcement can question me without the presence of counsel.

Signed (youth): __________________________________ Date: _______

Signed (parent/guardian): __________________________ Date: _______

Relationship: ____________________________________

Signed (Witness): ________________________________ Date: _______

Time: __________

YCC 60-1 (M) / Implemented 11-06-06

Juvenile Advisory of Rights, Parental Notification and Waiver Form

As received by the Department of Justice, Appellate Services Bureau 04-03-06

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Juvenile Advisory Of Rights, Parental Notification And Waiver Form - Montana Department Of Justice Page 2