1. I herewith tender my driver's license and proof of insurance.
2. If I am not in custody, I understand that I do not have to answer any questions or volunteer any information. Therefore,
I choose not to make any statements or answer any questions. Furthermore,
I choose not to take any voluntary roadside field sobriety evaluations
or any handheld
breath tests.
3. I have committed no crime and respectfully request that my driver's license, insurance card, and any other of
my documents in your possession be returned to me immediately.
4. If I am not allowed to leave at this time, I will assume that this is more than a brief investigatory stop and that I am in custody (under arrest). I therefore invoke my
RIGHT TO REMAIN SILENT including my right not to take any of the aforementioned roadside field sobriety evaluations.
5. Without waiving any deficiencies in the statutory procedures or the implied consent notice, if I consent to any official state tests of my blood, breath, urine, or other bodily substance, I further request that I be allowed to take an
independent test at a private medical facility by personnel of my own choosing and at my own expense.
6. I DO NOT CONSENT TO A SEARCH of my person, my vehicle, or any of my property.
7. I INVOKE MY RIGHT TO A LAWYER and request that I be allowed to call
my attorney.
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