Form Center

Step One

You have been selected as a prospective juror for the Courts of Jefferson County for January-December 2024. If chosen, you will be notified by separate summons as to the day and time you must appear. The following form is designed to assist the Court and the lawyers. It will not be used for any other purpose. This questionnaire is confidential.
Name*
Juror #*
Age*
Address*
City*
State*
Zip Code*
If you work outside the home, what is your occupation and who is your current employer?
If you are married or if you live with a companion, what is her or his name and occupation, if any?
With respect to other members of your household, if any, please state their names, ages, occupations, and employers, if applicable:
Have you or anyone close to you ever been the victim of a crime? If yes, please explain:
Are you or any member of your family related to, or a close friend of any law enforcement officer? If yes, please explain:
Have you ever been called for jury service before? If so, what was the outcome of the case?
Continue

Which television programs, if any, do you regularly watch?
How do you spend your free time?
Please list any organizations or associations to which you belong, such as PTA, social clubs, political organizations, etc.:
Please list any organizations or associations to which your spouse/partner, if any, belongs:
Do you have any disabilities or health related problems which would make it difficult for you to serve as a juror? If so, please explain:
Do you or have you suffered from a mental illness? If yes, please explain:
Do you have any pressing matters of a family or personal nature which would make it difficult or impossible for you to serve as a juror?
Do you prefer to be alone or with others?
Do you consider yourself as a leader or a follower?
Continue |Go Back

Do you have a family member or close friend who works in the legal system as a judge, lawyer, court reporter, paralegal, legal secretary or law enforcement officer: If you answered yes, please explain:
Have you, a family member or close friend ever been charged with a crime? If you answered yes, please explain:
What do you think are the three biggest problems in your community?
Please list answers using 1), 2), 3)
How do you feel about rules?
Have you or anyone close to you been convicted of a felony? If you answered yes, please explain:
Are you currently on probation or serving a sentence of house arrest, work release or under suspended sentence?
Is there any information which you would like to provide to the Court that you believe is relevant to your ability to serve as a juror in this case?
Continue |Go Back