I hereby invoke and refuse to waive all of the following rights and privileges afforded to me by the U.S. Constitution:
• I invoke and refuse to waive my Fifth Amendment right to remain silent. Do not ask me any questions.
• I invoke and refuse to waive my Sixth Amendment right to an attorney of my choice. Do not ask me any questions without my attorney present.
• I invoke and refuse to waive all privileges and rights pursuant to the case Miranda v. Arizona. Do not ask me any questions or make any comment to me about this decision.
• I invoke and refuse to waive my Fourth Amendment right to be free from unreasonable searches and seizures. I do not consent to any search or seizure of myself, my home, or of any property in my possession. Do not ask me about my ownership interest in any property. I do not consent to this contact with you. If I am not presently under arrest or under investigatory detention, please allow me to leave.
• Any statement I make, or alleged consent I give, in response to your questions is hereby made under protest and under duress and in submission to your claim of lawful authority to force me to provide you with information.