Form JURY-003 Juror Questionnaire - California

Form JURY-003 is a California Superior Court form also known as the "Juror Questionnaire". The latest edition of the form was released in September 1, 2018 and is available for digital filing.

Download a fillable PDF version of the Form JURY-003 down below or find it on California Superior Court Forms website.

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JURY-003
JUROR QUESTIONNAIRE
PLEASE PRINT ALL ANSWERS LEGIBLY
To facilitate the jury selection process, provide the requested information under penalty of perjury. The completed questionnaire will be
reviewed by all parties. The questionnaire is a public record and may be open to public inspection. If you believe that any question
requires an answer that is too sensitive (personal or private) to be included in the public record, you have the right to request a private
hearing, rather than writing the answer on the form. If you prefer to discuss this outside of the presence of other jurors, circle the
question and write "P" (for "private") in the space for the answer.
General Information
1.
FULL NAME:
2.
Age:
3.
Area, neighborhood, or community in this county where you generally live (do not give your street address):
HOUSE
APARTMENT
OWN
RENT
4.
Do you have children?
YES
NO
If yes, how many?
Ages:
Employment
5.
Are you employed?
YES
NO
If yes, occupation:
Current employer:
Relationship Information
6.
Are there other adults in your household?
YES
NO
If yes, their occupations:
Education
7.
High school graduate:
YES
NO
YES
NO
College graduate:
YES
NO
Postgraduate degree:
8.
If college or postgraduate degrees, degrees obtained:
Prior Jury Service
9.
Have you served on a jury before?
YES
NO
If yes:
Civil
Criminal
Other Experience
10.
Have you, a relative, or a close friend ever sued anyone or been sued?
YES
NO
If yes, describe:
11.
Do you or does anyone close to you have training or expertise in any of the following areas (check all that apply):
Evaluating claims for loss or damage
Law enforcement
Law
Accident reconstruction or biomechanics
Medicine
Specialized training in
12.
Is there any matter not covered by this questionnaire that could affect your ability to understand the proceedings or to be a fair and
impartial juror?
YES
NO
If yes, describe:
I declare under penalty of perjury under the laws of the State of California that the responses I have given on this
questionnaire and on any attached sheets are true and correct to the best of my knowledge and belief.
Date:
(SIGNATURE OF JUROR)
Cal.Rules of Court, rule 3.1549
Form Approved for Optional Use
Juror Questionnaire for Expedited Jury Trials
www.courts.ca.gov
Judicial Council of California
JURY-003 [Rev. September 1, 2018]
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form
JURY-003
JUROR QUESTIONNAIRE
PLEASE PRINT ALL ANSWERS LEGIBLY
To facilitate the jury selection process, provide the requested information under penalty of perjury. The completed questionnaire will be
reviewed by all parties. The questionnaire is a public record and may be open to public inspection. If you believe that any question
requires an answer that is too sensitive (personal or private) to be included in the public record, you have the right to request a private
hearing, rather than writing the answer on the form. If you prefer to discuss this outside of the presence of other jurors, circle the
question and write "P" (for "private") in the space for the answer.
General Information
1.
FULL NAME:
2.
Age:
3.
Area, neighborhood, or community in this county where you generally live (do not give your street address):
HOUSE
APARTMENT
OWN
RENT
4.
Do you have children?
YES
NO
If yes, how many?
Ages:
Employment
5.
Are you employed?
YES
NO
If yes, occupation:
Current employer:
Relationship Information
6.
Are there other adults in your household?
YES
NO
If yes, their occupations:
Education
7.
High school graduate:
YES
NO
YES
NO
College graduate:
YES
NO
Postgraduate degree:
8.
If college or postgraduate degrees, degrees obtained:
Prior Jury Service
9.
Have you served on a jury before?
YES
NO
If yes:
Civil
Criminal
Other Experience
10.
Have you, a relative, or a close friend ever sued anyone or been sued?
YES
NO
If yes, describe:
11.
Do you or does anyone close to you have training or expertise in any of the following areas (check all that apply):
Evaluating claims for loss or damage
Law enforcement
Law
Accident reconstruction or biomechanics
Medicine
Specialized training in
12.
Is there any matter not covered by this questionnaire that could affect your ability to understand the proceedings or to be a fair and
impartial juror?
YES
NO
If yes, describe:
I declare under penalty of perjury under the laws of the State of California that the responses I have given on this
questionnaire and on any attached sheets are true and correct to the best of my knowledge and belief.
Date:
(SIGNATURE OF JUROR)
Cal.Rules of Court, rule 3.1549
Form Approved for Optional Use
Juror Questionnaire for Expedited Jury Trials
www.courts.ca.gov
Judicial Council of California
JURY-003 [Rev. September 1, 2018]
For your protection and privacy, please press the Clear
This Form button after you have printed the form.
Print this form
Save this form
Clear this form

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