Appendix K - Law Enforcement Officers Bill of Rights - Pg1500

FORM 12-11 LAW ENFORCEMENT OFFICERS’ BILL OF RIGHTS - EPD1200.0 EDMONSTON POLICE DEPARTMENT 5005 52ND Avenue Edmonston, Maryland 20781 (301) 699-8805

Date: ______

TO: ______

FROM: ______

SUBJECT: Imposition of Disciplinary Action - ICN # ______

I have received and reviewed an investigative report prepared by ______concerning your actions of ______.

This report indicates a sustained finding. Therefore you are charged as follows:

Charge; ______

To Wit; ______In light of the aforementioned, I intend to take the following disciplinary measures.

WAIVER OR ACCEPTANCE OF PUNISHMENT

I do not dispute the facts as stated above.

I do accept the punishment as offered.

I do waive my rights to a hearing board as provided for in the Law Enforcement Officers' Bill of Rights.

If summary punishment is a letter of reprimand, I understand and accept this document as the official letter of reprimand.

I do dispute the facts as stated and do not accept the punishment offered. I request a hearing board as provided in the Law Enforcement Officers' Bill of Rights.

I do not accept the punishment, agree with facts, and request hearing.

RESPONDENT OFFICER'S SIGNATURE: ______

SERVED BY: ______DATE: ______TIME: ______FORM 12-11 LAW ENFORCEMENT OFFICERS’ BILL OF RIGHTS - EPD1200.0

NOTICE TO RESPONDENT

You must sign this form and indicate one or more of the above options. This form must be returned to the office of the Chief of Police, within seventy-two (72) hours of receipt. If this form is a letter of reprimand, and you accept it, the form will be placed in your personnel file.

Should you request a hearing, you are hereby advised that you have the right to legal representation or representation by someone of your choosing, and a hearing on the disputed issue(s) before an administrative hearing board in accordance with Public Safety Article-Title 3, Subtitle 1, Section 3-104 (J) and Section 3-107 (A).

Return Received By: ______Date: ______