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Questionnaire as to Qualification for Jury Service
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3. Please state the round trip mileage from you home to City Hall
4. Telephone: Home/Cell
5. How long have you resided there?
Number of years in Montana?
6. Marital Status
7. Do you have children?
8. What education have you had:
9. Are you employed at present?
10. Employer's name
11. a. If you are married, name of spouse
b. If married, occupation of spouse
c. If retired, or not working, give last occupation
d. If married, give spouse's employer
12. Have you ever served as a juror?
If so, in what court?
13. Have you or any member of your immediate family ever been injured in an accident?
If so, what type?
14. Are you or any member of your immediate family involved in law enforcement in any official capacity?
If so, briefly explain
15. Have you or any member of your immediate family ever been a plaintiff or defendant in a lawsuit?
If yes, what type of lawsuit?
16. Are you or your spouse related to an attorney?
If so, his/her name and address
17. Are you or your spouse presently being represented by an attorney?
If so, his/her name and address
18. Do you have any disability which you feel would make it difficult to serve on a jury?
If so, briefly explain the disability and the accommodations we need to provide to enable you to serve on a jury.
19. In order to be eligible to serve as a trial juror, you must be 18 years of age or older, a resident for at least 30 days of the state and of the city, town or county in which you are called for jury duty, a citizen of the United Sates and not convicted of malfeasance in office or any felony or other high crime, the sentence of which has not yet expired or the fine not yet paid.
20. Do you feel you should be excused from serving as a juror because of undue hardship or because you do not meet the eligibility requirements for jury service?
If you answered "yes", please complete the Affidavit for Excusal form linked on the Trial Summons Page.
I certify that the foregoing statements are true to the best of my knowledge and belief.
(Sign this form by typing your name on the signature line above)
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