Juror Confirmation Form
TRIAL JUROR CONFIRMATION FORM
The Juror Confirmation Form (the Form), page 3 of your summons package, is a postcard which must be completed, signed, and mailed back to the Office of Jury Commissioner (OJC) within 10 days of receipt of a juror summons. If you have lost the Form, contact us immediately at 1-800-THE-JURY [1-800-843-5879]. If you are Hearing Impaired and have a TTY Device, please contact us at 1-800-328-3202. (If you do not have a TTY Device, you will not be able to get through on this number.)
INSTRUCTIONS FOR COMPLETING.
1. Text With Images: (Click here to access instructions using text with images).
2. Instructions Using Text Only, (displayed immediately below)
TEXT ONLY INSTRUCTIONS
for COMPLETING the
TRIAL JUROR CONFIRMATION FORM
STEP #1: Read Page 5, entitled "Reasons For Disqualification," of the pamphlet entitled "Juror Instructions And Information" that came as a part of your summons package.
(Click here to view this information online)
STEP #2: If, after reading the above, you find that you are qualified to serve as a juror, place an X in the blue box to the right of SECTION A of the Form. Skip Sections B and C and proceed to STEP #4.
STEP #3: If, after reading the above, you find that your are not qualified, place an X in the blue box in SECTION B under the appropriate reason number. In SECTION C provide the details as you were instructed in the "Reasons For Disqualification." However, if you claim reason 9 or 10, you must send a doctor's letter along with the Form in an envelope to the address on the postcard. Proceed to STEP #8.
STEP #4: SECTION D lists the optional courthouses you may request to transfer your juror service to in case of hardship. You may request to change the location of the courthouse where you shall appear to perform your juror service only if:
1. You have a hardship in getting to the courthouse.
Examples of such hardships include:
- You do not have a car, there is no one to drive you, and there is no public transportation available;
- For medical reasons you cannot travel long distances;
- Your childcare arrangements make it impossible for you to appear at your assigned courthouse at the designated time; or
- You are physically disabled and the courthouse you have been assigned to is not wheelchair accessible.
(Click here to see if the courthouse you have been assigned to is accessible.); and
2. There is at least one alternative courthouse listed in SECTION D of the Form, and you have a hardship as defined above. (If the name of your preferred court does not appear, it is either fully scheduled or is not a court which uses jurors.)
REMEMBER: MERE INCONVENIENCE IS NOT SUFFICIENT REASON TO WARRANT A COURTHOUSE TRANSFER.
(Please note that grand jurors may not request a courthouse transfer.)
(Click here for further details regarding courthouse transfers.)
If you do not meet the hardship criteria, proceed to Step #6.
STEP #5: If you believe you have a hardship, place an X in the blue box to the left of the name of the desired courthouse in SECTION D. In the two lines beneath the list of optional courts provide a brief, but detailed explanation of your hardship. Proceed to Step #6 if you wish to postpone your date of service or Step #7 if you do not.
STEP #6: SECTION E allows you to exercise your privilege to postpone your date of juror service. You may request to postpone to any court business day, provided the date you select is within 12 months of the date for which you were originally summonsed. In the six blue boxes in Section E, place your desired date in the format "MMDDYY," where MM is the two-digit month number (include a leading zero if necessary), where DD is the two-digit date number (include a leading zero if necessary), and where YY is the two-digit year number (include a leading zero if necessary). (See the example on the Form.)
STEP #7: SECTION F applies to jurors who are hearing impaired and will require an FM assistive listening device. If you know such a device will help you, then complete Section F on the Form by placing an X in the blue box. If you should have questions and have a TTY device, please call our TTY number at 1-800-328-3202.
STEP #8: Whether you will serve or not, please complete the optional survey contained in SECTION G. The information obtained will be used in efforts to ensure that the composition of the jury pool reflects the diversity of the population of the district. Place an X in any appropriate box next to the designation(s) that applies to you.
STEP #9: SECTION H: Date and sign the Form.
STEP #10: Mail the Form immediately (you do not need a stamp).
PLEASE NOTE: On the Form, you will find a twelve-character JUROR ID#. This is the unique identification number the computer has assigned you for the life of this summons; use it in any verbal, electronic, or written communication with the OJC.
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