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Lower front of Your Summons

Front of the Questionnaire

The front of your Questionnaire must be completed by all potential jurors summoned. Complete each section and sign your affidavit in the red box near the top left hand corner. Then turn the questionnaire over and complete the back of the questionnaire.

Juror Information

Provide us with all the information including any address changes so that we may properly process your affidavit. This information may also help in the courtroom during jury selection.

Waive Your Jury Fees/Mileage

If you wish to waive any fees paid to you for service and mileage, check this box. If you are required to surrender your fees to your employer, because your salary is continued while you are serving – do not check this box. Check your employer’s policy before waiving fees.

Interested in the Orange County Grand Jury?

If you are interested in volunteering to serve as an Orange County Grand Juror, check this box. You will be mailed additional information. You are also invited to view the Orange County Grand Jury web pages for more information. http://www.ocgrandjury.org.

ADA Accommodations

If you would like to serve as a juror, but require accommodations; let us know by completing this statement.