Hints for Completing the Qualification Questionnaire

BASIC INFORMATION ON QUESTIONS 1 - 8

#1.  Please insert full name. CORRECT FROM NAME PRINTED ABOVE IF NECESSARY.
#2.  Birth Date - Please insert Correct Birth Date
#3.  Insert Address. CORRECT FROM ADDRESS PRINTED ABOVE IF NECESSARY.
#4.  Insert estimated round trip miles.
#5.  County should be Muskegon
#6.  Please denote City, Township or Village
#7.  Please list phone number
#8.  If employed, please list work phone number.

HINTS WHEN MARKING SPECIFIC QUESTIONS

#9.  If you are over 70 years of age and wish to be permanently exempt, mark the YES box.  Verify that you have listed your Birth Year correctly.  Sign and date at the bottom of the page.  No Other questions need to be answered. Mail your questionnaire.

#13.  Are you physically or mentally able to carry out the functions of a juror?
If you mark the NO box...you must enclose a copy of a statement from your doctor or medical facility.  If a doctor's statement is not available, detail the problem on the lines provided below the question.

#14.  Have you served as a juror during the past 12 months?  According the Michigan Compiled Law 600.1307a., a person has served as a juror if that person has been paid for jury service. The Jury Board/Jury Clerk checks to verify the dates served if the YES box is marked.

#15. Have you ever been convicted of a felony? If you mark the YES box, state the city, state and date of the felony conviction.

SPECIAL INFORMATION

STUDENT - Parent can return questionnaire with Local/State/National name & location.  Sign, date, & return.  No need to forward to student.

MILITARY - Parent/Spouse/or designated person can return questionnaire with service location of Military person selected.

DECEASED -  Note Basic Information on Top of Questionnaire and return questionnaire to jury commission.

[Click here to see a sample Juror Qualification Questionnaire in Adobe Acrobat format]
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