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BUTTE-SILVER BOW ANIMAL SERVICES DEPARTMENT VOLUNTARY STATEMENT I, whose address is Declare that the following voluntary statement is made to the a foresaid person of my own free will without a promise of hope or reward, without fear or threat of physical harm, without coercion, favor or offer of favor, without leniency, by person or persons whomsoever. I understand that it is a violation of law to knowingly give false information to law enforcement authorities. Section 45-7-205, MCA I have read this statement consisting of page(s), and I certify that the facts contained therein are true and correct, I also declare that I was not told or prompted what to say in this statement. Date this day of Name: Address: Drivers License Phone: Signature of person giving voluntary statement ---PAGE BREAK--- Signature of person giving voluntary statement Phone [PHONE REDACTED] Fax [PHONE REDACTED] 699 Centennial Avenue Butte, Montana 59701