SBar-0a.jpg (61082 bytes)COMPLETING
the

GRAND JUROR
CONFIRMATION
FORM

(The Form)

(Text with Images Version)

 

Image of the Grand Juror Confirmation Form.

 

 

 

 

 

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; please use it in any verbal, electronic, or written communication with the Office of Jury Commissioner. Image of the location of the Juror ID number.
STEP
1
Read Page 4, "Reasons For Disqualification," of the pamphlet entitled "Grand Juror Instructions And Information" that came as a part of your summons package. 
Click here SEAL-BUL.jpg (1975 bytes) to view this information online.

Image of the front cover of the "Grand Juror Instructions and Information" pamphlet.

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. Image of the location of the Section A.
STEP
3A
If, after reading the above, you find that you are not qualified, place an X in the blue box in Section B under the appropriate reason number.  Image of the location of the Section B.
STEP
3B
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 #6. Image of the location of the Section C.
STEP
4
Section E grants you the opportunity to exercise your privilege to postpone your date of juror service.  You may request to postpone to the months of January, April, July, or October, provided the month you select is within 12 months of the date for which you were originally summonsed.  In the four blue boxes in Section E, place your desired date in the format "MM   YY," where MM is the two-digit month number (include a leading zero if necessary) and where YY is the two-digit year number (include a leading zero if necessary). Image of the location of the Section E.
STEP
5
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 have questions and have a TTY device, please call our TTY number at 1-800-328-3202. Image of the location of the Section F.
STEP
6
Whether you are qualified to 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. Image of the location of the Section G.
STEP
7
Section H: Date and sign the Form, and remove the black tab at the top it. Image of the location of the Section H.

Image of the location of the removable tag on the Grand Juror Confirmation Form.

STEP
8
Mail the Form immediately (you do not need a stamp).  If your current mailing address is different from the one to which your summons was addressed or your name has changed or is misspelled, then please make the necessary corrections in the area provided on the mailing side of the Form as shown on the right. Image of the Business Reply Card.

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