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:

1. Last name

PLEASE PRINT CLEARLY

First name

Middle initial

2. Indicate city, township, or village in which you live.

City

Township

Village

of:

3. What is your occupation?

4. What other occupations have you had in the last 10 years?

5.Have you ever held office in any state, county, or municipality, or have you ever been a law enforcement officer?

Yes

If yes, please specify.

6. What was the last grade you completed in school,

or degree received?

7. Marital status
Widowed

Single
Separated

Married
Divorced

8. Name of spouse

9. Spouse’s occupation

10. Number of children living at home

11. Check if you are

Property owner

Tenant
Landlord

12. Do you drive?

Yes

13. a. Have you, a family member, or a close friend ever been in a serious traffic accident?

Yes

b. Was alcohol involved?

Yes

c. Who was injured?
Yourself

Family member(s)

Other(s)

No one

14. Have you ever been a victim, witness, plaintiff, or defendant in a criminal or civil suit?

Yes

If yes, explain?

If yes, what?

15. Have you ever been convicted of a crime?

Yes

16. Are there any special accommodations the court needs to make to assist you in serving as a juror?

Yes

If yes, please explain the accommodations that would be necessary.

Date

/s/
Signature

MC 321b (9/17) JUROR PERSONAL HISTORY QUESTIONNAIREMCR 2.510Approved, SCAO STATE OF MICHIGANJUDICIAL DISTRICTJUDICIAL CIRCUITCOUNTY PROBATEJUROR PERSONAL HISTORY QUESTIONNAIREJUROR NO.Court addressCourt telephone no.

MC 321b, Juror Personal History Questionnaire

This info page is part of the LIT Lab's Form Explorer project. It is not associated with the Michigan 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 www.courts.michigan.gov/general-use (2023-03)
Page(s): 1
Fields(s): 49
Average fields per page: 49
Reading Level: Grade 8
LIST Grouping(s): Unknown

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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.

juro_r was JUROR NO (0.67 conf)
city_township_village_live was 2 Indicate city township or village in which you live (0.32 conf)
users1_address_city was City (1.00 conf)
township was Township (0.24 conf)
village was Village (0.36 conf)
occupation was 3 What is your occupation (0.48 conf)
occupations_last_years was 4 What other occupations have you had in the last 10 years (0.35 conf)
state_law_enforcement_officer was 5Have you ever held office in any state county or municipality or have you ever been a law enforcement officer (0.56 conf)
grade_school_degree was 6 What was the last grade you completed in school or degree received (0.33 conf)
undefined__1 was undefined_2 (0.39 conf)
undefined__2 was undefined_3 (0.39 conf)
undefined__3 was undefined_4 (0.39 conf)
undefined__4 was undefined_5 (0.39 conf)
undefined__5 was undefined_6 (0.39 conf)
name_spouse was 8 Name of spouse (0.39 conf)
spouses_occupation was 9 Spouses occupation (0.38 conf)
number_children_living_home was 10 Number of children living at home (0.37 conf)
undefined__6 was undefined_7 (0.39 conf)
undefined__7 was undefined_8 (0.39 conf)
undefined__8 was undefined_9 (0.39 conf)
undefined__9 was undefined_10 (0.39 conf)
undefined__10 was undefined_11 (0.39 conf)
undefined__11 was undefined_13 (0.39 conf)
undefined__12 was undefined_14 (0.39 conf)
undefined__13 was undefined_15 (0.39 conf)
undefined__14 was undefined_16 (0.39 conf)
undefined__15 was undefined_17 (0.39 conf)
undefined__16 was undefined_18 (0.39 conf)
ever_convicted_crime was 15 Have you ever been convicted of a crime (0.45 conf)
special_make_assist was 16 Are there any special accommodations the court needs to make to assist you in serving as a juror (0.41 conf)
signature_date was Date (1.00 conf)
text__1 was Text1 (0.35 conf)
text__2 was Text2 (0.35 conf)
text__3 was Text3 (0.35 conf)
text__4 was Text4 (0.35 conf)
text__5 was Text5 (0.35 conf)
text__6 was Text6 (0.35 conf)
text__7 was Text7 (0.35 conf)
text__8 was Text8 (0.35 conf)
check_box__1 was Check Box9 (0.37 conf)
check_box__2 was Check Box10 (0.37 conf)
check_box__3 was Check Box11 (0.37 conf)
check_box__4 was Check Box12 (0.37 conf)
check_box__5 was Check Box13 (0.37 conf)
check_box__6 was Check Box14 (0.37 conf)
check_box__7 was Check Box15 (0.37 conf)
check_box__8 was Check Box16 (0.37 conf)
check_box__9 was Check Box17 (0.37 conf)
check_box__10 was Check Box18 (0.37 conf)

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

MC 321b, Juror Personal History Questionnaire

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