VOLUNTARY STATEMENT (NOT UNDER ARREST)
THE STATE OF TEXAS:
Under the Texas Penal Code- Sec. 37.08 False Report to a Peace Officer
(a) A person commits an offense if, with intent to deceive, he knowingly makes a false statement
to a peace officer conducting a criminal investigation and the statement is material to the
investigation.
Name: Date
of Birth:
SSN:
Cell/Pager #:
Sex: Race:
Driver’s License or ID #:
Address:
Home Phone #: Work #:
Employer & Address:
Nearest relative or friend
who always knows your whereabouts:
Name:
I
DO NOT wish to pursue criminal charges.
Describe the incident in detail:
DO
Address:
Phone:
F
SIGNATURE DATE
WITNESSED BY DATE
Describe the incident in detail:
Incident details continued:
I have read the above statement, which is freely and voluntarily made, and I find it true and correct
to the best of my knowledge and belief. I have completed years of school and can read
and write the English language.
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