• District Court Juror Questionnaire

  • Thank you for using the online process to respond to your jury summons. Because of COVID-19, we have created this form to be completed ahead of time to help prevent forms from passing hand to hand on jury selection day. 

     

    Below you will find a series of questions. This form is secure and confidential. Please fill out the information below before the deadline listed on your summons. Please be sure to provide an e-mail address that is valid and that you check regularly. If you are excused from jury service based on your responses below, or if the jury panel is canceled, you will be notified by e-mail. 

  • Format: (000) 000-0000.
  • Date Listed for Appearance on Jury Summons*
     - -
  • Are you a U.S. Citizen?*
  • Gender*
  • Race (required by Texas Law)*
  • Date of Birth*
     - -
  • Current Marital Status?*
  • Please check the highest level of education you have completed?*

  • Exemptions

    You have a right to claim an exemption from jury service if one of the following apply to you. You DO NOT have to claim an exemption if you do not want to. This is optional and up to you. By selecting an option below, you are swearing under penalty of perjury that your answer is true and correct
  • List of Possible Exemptions:*

  • Disqualifications

    Section 62.102 of the Texas Government Code require that you meet the following minimum qualifications to serve on a Jury in Texas. Please select all that apply below. If you select an option, you are not automatically excused from Jury Service until you receive an e-mail confirming your disqualification. By selecting an option below, you are swearing under penalty of perjury that your answer is true and correct
  • Select any of the following disqualifications that may apply:*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • Certification of Questionnaire

  • Clear
  • Date Signed*
     / /
  • Should be Empty:
Select theme:
  • Default
  • Blue
  • Red
  • Brown
  • Green
  • Black
  • Pink
  • Dark Blue
  • Purple