NOTICE TO OFFICER

I am herewith handing to you this written statement, my driver's license and other documents in connection with this vehicle. I believe these papers properly identify me, show proper insurance and state clearly what I intend to say and do. I have committed no crime or traffic offense, to my knowledge. After you have verified the information presented to you, I wish to be on my way.

Unless you advise me that I can leave now, I will conclude that this delay in my travel is more than a brief investigatory stop. It will then seem clear to me that my liberty to act freely, or as I wish, is restricted by the imposition of your authority. It would be reasonable for me to feel that you have placed me under arrest.

Officer, I am aware that I must obey your lawful orders without resistance. I also understand I do not have to obey simple requests you may make which are discretionary for me to act or not to act. I state now that I do not wish to act upon any requests that are not orders incident to my arrest. Charge me now or let me go.

I do protest your efforts. Should I be required by you to exit my vehicle against my will, it will be evident to me that I am under arrest. I am not going to answer any more of your questions. Where I have been or what I have been doing has no bearing on why you feel I should be stopped and detained in this manner. This written statement is my only statement and I will make no oral statements to you. I am employing this written statement, so there will be no confusion as to what I expect from you as an officer sworn to uphold the law. I also wish there to be no confusion as to what you may expect of me with regard to this incident. Please do not disregard the contents of this statement as I have several copies, one of which is in the possession of my attorney, who has advised me to employ this statement should a traffic stop or incident such as this occur. I make the following formal statements:

" I choose to employ my right to remain silent. (U.S. Const., 5th Amendment Ga. Const., Art. I, I, n XVI; O.C.G.A. 24-9-20.) I request that my attorney be present with me during any questioning or legal proceedings against me. I wish to speak with my attorney immediately, as permitted by law.

"I am aware that Georgia law does not require that I submit to your requests to engage in any verbal or non-verbal field sobriety Tests. These could include, but would not be limited to the alcosensor (or any hand-held alcohol breath monitor) walk-and-turn, the horizontal gaze nystagmus evaluation reciting the alphabet, one leg stand or other such exercises. Please do not ask me to participate in any such evaluations, unless my attorney is present. If you ignore my Constitutional and statutory rights as invoked in this statement, or if you verbally or physically threaten me with physical violence, I will perform them, but not of my own free will. My purpose in this is not to interfere with or obstruct you in any way. I merely wish to exercise my right under Georgia law not to give evidence in any form, verbal or by any physical activity against myself."

"I will consent to submit to tests of my breath, urine, blood or other bodily substances which you may designate, under Georgia Implied Consent laws. I will do so, provided the tests are properly administered. This means the tests strictly comply with all State, Federal regulatory and statutory provisions. These tests should be conducted by a person certified to administer the tests. I wish to be personally assured that the tests and testing devices being used are properly approved by the Forensic Sciences Division of the G.B.I., in compliance with all regulations and rules validly established under the Georgia Administrative Procedure Act, O.C.G.A. 8 50-13-1 et seq. I wish to see the permit of each person holding himself out to be so certified, prior to submitting to such tests.

"Please do not ask me to sign anything, of any nature, at any time during which I am in custody, unless I am advised by my attorney. I choose not to do so. Please respect that reasonable wish. Any signature your force me to provide will be coerced and I hereby deny any willingness to volunteer to scribe my signature on any document, including (particularly) any receipts for property, inventory service of process or otherwise."

"I believe you have no cause to make a request for a chemical sobriety test. I will agree to take such tests, but only under protest. Please read slowly the advisements you are giving me, or in the procedures that you wish me to follow. I wish to be given a copy of the implied consent rights warning which you read to me. I must insist that any chemical sobriety tests be given only with devices which are functioning properly. This means that all electronic and operating parts and components designated by the machine's manufacturer are in good working order and that all parts are properly attached and maintained. I wish to be provided [under O.C.G.A. 40-6-392 with full disclosure of information concerning the tests you designate. I wish further to be given a written copy of any report of the results of these tests.

"I expect and hereby demand that a sample of my blood be collected and after being properly sealed and refrigerated to prevent deterioration, be held for re-analysis at a later date. I request a calibration check be made on whatever machine is used to determine if it is calibrated correctly, that is, against a known-strength alcohol reference sample.

"If, you charge me with any DUI offense, then I request that I be immediately transported to the nearest available private medical facility to be designated by me at that time, which will conduct independent testing. I wish to be independently tested even if your test fails, or does not yield a numerical result I will select my own medical provider to administer my independent tests. I will arrange my own financial transactions upon arrival at the selected facility. I will choose my own tests and I will need and hereby request a telephone and telephone directory to arrange this. I would suggest this occur during the observation period prior to the state-administered tests.

"Please do not search me or my vehicle or other property. I wish for my vehicle to remain where it is presently located pursuant to O.C.G.A.§ 40-11-9. Please allow me to lock it and attach a note indicating that it will soon be removed by a private tow company of my choosing and please allow me access to a telephone for that purpose. This document is all your department will need to release you and your police department from any liability resulting from leaving the vehicle at the present location, provided you observe my above-stated wishes concerning my vehicle."

"As I am considered an innocent person under the law I do not wish to be videotaped or audiotaped. Doing so, without my written consent would constitute a violation of my privacy rights to under both the Georgia and U.S. Constitutions.

"Finally, and most importantly, as this statement represents potential documentary evidence in any jury trial which would certainly occur if I am arrested, please exercise very carefully your duty and sworn obligation to keep and preserve all evidence involving this case, which now would include this statement which has been placed into your hands. I hereby request you attach this statement directly to any citation or other official report that you may issue, so that it may be turned over to the prosecutor's office with other evidence."

This _____ day of ________, 200___

_______________________________
Signature of Driver

Copyright 1999-2005 All Rights Reserved

E.H. (Pete) Young, Attorney 1-800-841-6844

561 Greene St. Augusta, Ga.30901
706-724-8554

1010 East Victory Drive, Savannah, Ga. 31405
912-236-4308