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52A - Form 9
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52A - Form 9
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<br />Town of Lexington <br />Police Department <br />Chief Mark J. Corr <br /> <br />Notice of Employee Rights <br /> <br />1575 MASSACHUSETTS AVENUE • LEXINGTON, MASSACHUSETTS 02420 <br />781-862-1212/fax 781-863-1291 <br />IA Form - 9 <br /> <br /> <br />Employee name: ___________________________________ ID#: _____________________ <br /> <br />Today’s date: _______________ Time: _______________ Case#: ____________________ <br /> <br />Interviewing officer: _________________________________________________________ <br /> <br />Alleged misconduct: _________________________________________________________ <br /> <br />1. The purpose of this interview is to elicit responses that will assist the Department in determining <br />whether the alleged misconduct occurred. This is an administrative investigation relating to the <br />official business of the Lexington Police Department. <br /> <br />2. You will be asked questions that relate directly, narrowly, and specifically to the performance of your <br />official duties as an employee of the Lexington Police Department. <br /> 3. Although I am conducting an administrative interview, if you reasonably believe that this <br />investigation may result in a criminal prosecution against you: <br /> <br />a. You may exercise your Miranda rights and may refuse to answer any specific question if you <br />believe your answer could be used against you in a criminal prosecution. <br /> <br />b. If you refuse to answer questions, your refusal will not subject you to any disciplinary action by <br />the Department. Disciplinary action may nevertheless be taken against you based on other <br />information received by the Department. <br /> 4. Any answers that you provide may be used against you in any subsequent proceeding and could <br />result in administrative action against you, including dismissal. <br /> <br />5. If you are a member of a collective bargaining unit, you may request union representation to be <br />present if you reasonably believe that disciplinary action may result from this interview. <br /> <br />6. If you do not understand any part of this notice, please ask immediately so that clarification of this <br />document can be provided to you. <br /> Receipt of Notice <br /> <br />The undersigned hereby acknowledges that he/she has been given proper notice of the allegations and <br />privileges provided above. <br /> <br />Employee Signature: __________________________________ Date: _______________ <br /> <br />Interviewer’s Signature: ________________________________ Date: _______________
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