Juror Qualification Questionnaire

If you received a Juror Qualification Questionnaire (see form below) from the U.S. District Court, you are being considered for jury service. However, this is not a summons for jury service and you are not being called to report at this time.

The form is used to obtain information about you so that we can objectively determine whether you are qualified to serve as a juror in the court.

We encourage you to complete the questionnaire online by clicking on the link below. In order to log in you will required to enter the following information:

  • Your unique 9-digit participant number located to the right of your name and address on the questionnaire.
  • The first three letters of your last name, exactly as shown on the questionnaire. If your name is misspelled on the questionnaire or has changed, you will have an opportunity to correct it after you log in.
  • Your date of birth.

You must complete this form on-line within 10 days of receipt.

Have a question about this form? The jury staff has provided a list of Frequently Asked Questions available here.

 Questionnaire for "On-Line" Submission

 Questionnaire Form for "Mail-In" (Optional)