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Jury Questionnaire

The following "Juror Questionnaire" is mandated by Government Code, Section 62.0132


Your answers are CONFIDENTIAL under Government Code, Section 62.0132, and may only be disclosed to the judge, court personnel, the litigant, and the litigant's attorney.

* Denotes a required field

*Jury Summons Number Please enter all 15-17 digits
*Last Name
*First Name
Middle Name
*Date of Birth (Format MM/DD/YYYY)

*Home Address
Mailing Address (If Different)
*County Of Residence
*Home Phone
*Mobile Phone
*Preferred Method Of Contact

*Your Occupation
*Your Employer
*How Long?
*Current Marital Status

Spouse's Name
Spouse's Occupation
Spouse's Employer
How Long?
*Are you a U.S. Citizen? Note: If you state that you are not a U.S. citizen, you may no longer be eligible to vote and may be required to provide proof of U.S. citizenship to your county voter registrar.

*Highest Level Of Education Completed

*Number of Children
Age Ranges
Have you ever served on a civil jury?
Have you ever served on a criminal jury?
QUALIFICATIONS FOR JURY SERVICE (Texas Government Code, Section 62.102) If you do not meet all of the below qualifications you cannot serve. Mark any that do not apply to you.

EXEMPTIONS FROM JURY SERVICE (Texas Government Code, Section 62.106) You may choose an exemption but are not required to.

*Payment for first day of jury empanelment is $10.00. Do you wish to:

*I certify that all answers are true and correct E-sign box

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