The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02

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Here is the text we could read:

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.

JURY-003

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

Current employer: 

4.

Do you have children?  

If yes, how many? 

Ages:

Employment

5.

Are you employed?

If yes, occupation: 

Relationship Information
6.

Are there other adults in your household?

If yes, their occupations: 

Education
7.

High school graduate:

College graduate: 

Postgraduate degree:

Prior Jury Service

9.

Have you served on a jury before?

If yes:

Civil  

Criminal

Other Experience
10.

If yes, describe:

8.

If college or postgraduate degrees, degrees obtained: 

Have you, a relative, or a close friend ever sued anyone or been sued? 

YES

YES

YES

YES

YES

YES

YES

YES

RENT

NO

NO

NO

NO

NO

NO

NO

NO

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

Accident reconstruction or biomechanics

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?
NO

YES

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. 

Juror Questionnaire for Expedited Jury Trials

Cal.Rules of Court, rule 3.1549 
www.courts.ca.gov

(SIGNATURE OF JUROR)

Law

Medicine

If yes, describe:

Date:

Form Approved  for Optional Use 
Judicial Council of California  
JURY-003  [Rev. September 1, 2018]

Juror Questionnaire for Expedited Jury Trials

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the California state courts. To learn more about the project, check out our about page.

Downloads: You can download both the original form (last checked 2023-03) and the machine-processed form with normalized data fields.

About This Form:

Sourced from selfhelp.courts.ca.gov (2023-03)
Page(s): 1
Fields(s): 43
Average fields per page: 43
Reading Level: Grade 8
LIST Grouping(s): Unknown

Use our Rate My PDF tool to learn more. Go beyond the above insights and learn more about this or any pdf form at RateMyPDF.com, includes: counts of difficult words used, passive voice decetion, and suggestions for how to make the form more usable.

Identified Data Fields:

We have done our best to automaticly identify and name form fields according to our naming conventions. When possible, we've used names tied to our question library. See e.g., user1_name. If we think we've found a match to a question in our library, it is highlighted in green. Novel names are auto generated. So, you will probably need to edit some of them if you're trying to stick to the convention.

Here are the fields we could identify.

page_specialized_training was topmostSubform[0].Page1[0]._11\.specialized\.training[0] (0.60 conf)
topmost_subform_page_fill_text was topmostSubform[0].Page1[0].FillText1[0] (0.44 conf)
topmost_subform_page_atty_state_ft was topmostSubform[0].Page1[0].AttyState_ft[0] (0.43 conf)
topmost_page_text_field__1 was topmostSubform[0].Page1[0].TextField2[0] (0.36 conf)
topmost_subform_page_house_apt__1 was topmostSubform[0].Page1[0].HouseApt[0] (0.42 conf)
topmost_subform_page_house_apt__2 was topmostSubform[0].Page1[0].HouseApt[1] (0.42 conf)
topmost_subform_page_rent__1 was topmostSubform[0].Page1[0].OwnRent[0] (0.42 conf)
topmost_subform_page_rent__2 was topmostSubform[0].Page1[0].OwnRent[1] (0.42 conf)
topmost_subform_page_bar_ft__1 was topmostSubform[0].Page1[0].BarNo_ft[0] (0.42 conf)
topmost_subform_page_bar_ft__2 was topmostSubform[0].Page1[0].BarNo_ft[1] (0.42 conf)
topmost_subform_page_bar_ft__3 was topmostSubform[0].Page1[0].BarNo_ft[2] (0.42 conf)
topmost_subform_page_bar_ft__4 was topmostSubform[0].Page1[0].BarNo_ft[3] (0.42 conf)
topmost_subform_page_bar_ft__5 was topmostSubform[0].Page1[0].BarNo_ft[4] (0.42 conf)
topmost_subform_page_bar_ft__6 was topmostSubform[0].Page1[0].BarNo_ft[5] (0.42 conf)
topmost_page_text_field__2 was topmostSubform[0].Page1[0].TextField2[1] (0.36 conf)
topmost_subform_page_eleven__1 was topmostSubform[0].Page1[0].Eleven[0] (0.38 conf)
topmost_subform_page_eleven__2 was topmostSubform[0].Page1[0].Eleven2[0] (0.38 conf)
topmost_subform_page_eleven__3 was topmostSubform[0].Page1[0].Eleven3[0] (0.38 conf)
topmost_subform_page_eleven__4 was topmostSubform[0].Page1[0].Eleven4[0] (0.38 conf)
topmost_subform_page_eleven__5 was topmostSubform[0].Page1[0].Eleven5[0] (0.38 conf)
topmost_subform_page_eleven__6 was topmostSubform[0].Page1[0].Eleven6[0] (0.38 conf)
topmost_page_text_field__3 was topmostSubform[0].Page1[0].TextField2[2] (0.36 conf)
topmost_page_date_field was topmostSubform[0].Page1[0].DateField1[0] (0.40 conf)
topmost_subform_page_four__1 was topmostSubform[0].Page1[0].four[0] (0.40 conf)
topmost_subform_page_four__2 was topmostSubform[0].Page1[0].four[1] (0.40 conf)
topmost_subform_page_twelve__1 was topmostSubform[0].Page1[0].twelve[0] (0.40 conf)
topmost_subform_page_twelve__2 was topmostSubform[0].Page1[0].twelve[1] (0.40 conf)
topmost_subform_page_ten__1 was topmostSubform[0].Page1[0].ten[0] (0.40 conf)
topmost_subform_page_ten__2 was topmostSubform[0].Page1[0].ten[1] (0.40 conf)
topmost_subform_page_nine__1 was topmostSubform[0].Page1[0].nine[0] (0.40 conf)
topmost_subform_page_nine__2 was topmostSubform[0].Page1[0].nine[1] (0.40 conf)
topmost_subform_page_seven__1 was topmostSubform[0].Page1[0].seven[0] (0.40 conf)
topmost_subform_page_seven__2 was topmostSubform[0].Page1[0].seven[1] (0.40 conf)
topmost_subform_page_sevena__1 was topmostSubform[0].Page1[0].sevena[0] (0.40 conf)
topmost_subform_page_sevena__2 was topmostSubform[0].Page1[0].sevena[1] (0.40 conf)
topmost_subform_page_sevenb__1 was topmostSubform[0].Page1[0].sevenb[0] (0.40 conf)
topmost_subform_page_sevenb__2 was topmostSubform[0].Page1[0].sevenb[1] (0.40 conf)
topmost_subform_page_six__1 was topmostSubform[0].Page1[0].Six[0] (0.38 conf)
topmost_subform_page_six__2 was topmostSubform[0].Page1[0].six[0] (0.40 conf)
topmost_subform_page_five__1 was topmostSubform[0].Page1[0].five[0] (0.40 conf)
topmost_subform_page_five__2 was topmostSubform[0].Page1[0].five[1] (0.40 conf)
topmost_subform_page_crim was topmostSubform[0].Page1[0].Crim[0] (0.38 conf)
topmost_subform_page_civ was topmostSubform[0].Page1[0].Civ[0] (0.38 conf)

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The Legal Innovation & Technology Lab's Form Explorer Beta @ Suffolk Law School Last updated 2023-04-02

Juror Questionnaire for Expedited Jury Trials

About This Form:

Identified Data Fields:

Create an Interactive Version of this Form:

The Legal Innovation & Technology Lab's Form Explorer ^Beta @ Suffolk Law School Last updated 2023-04-02