Jury Duty Questionnaire

Type of Phone
Have you served on a jury within the last 2 years? *
Have you or any member of your immediate family been a party to any lawsuit? *
Have you ever been a party to a personal injury claim? *
Have you been convicted of a misdemeanor involving violence or dishonesty or served a sentence for such a crime within the last 5 years? *
Have you been convicted of a felony or served part of a felony sentence within the last 15 years? *
Do you have a personal, moral or religious objection to the drinking of alcoholic beverages? *
Are you a citizen of the United States? *
Do you live within the city limits of Sweet Home? *
(Unless notified otherwise, you will not be required to serve on those dates)
(If you seek an excuse from jury service due to your physical condition, please attach a doctor's verification of your condition.)
Files must be less than 2 MB.
Allowed file types: jpg jpeg png pdf doc.
I hereby declare that the responses to questions on this form are true to the best of my knowledge and I acknowledge that a knowingly made false statement of material fact may be punished by a fine or imprisonment or both. By typing my full name below, I am electronically signing my application.