In Re Amendments to the Oklahoma Uniform Jury Instructions

JUROR INFORMATION QUESTIONNAIRE

IN THE CIRCUIT COURT OF COUNTY,

NAME OF PLAINTIFF NO.

V.

NAME OF DEFENDANT

IMPORTANT JUROR QUESTIONNAIRE:

This Questionnaire must be completed and returned within five days of your receipt of this letter.

Dear Potential Juror:

Your name has been drawn from the list of jurors to serve as a potential juror. In the jury selection process before a trial begins, lawyers must often ask many questions of each juror, in order that a constitutionally fair jury may be selected. This process may last a long time. To save both you and the Court time, and still provide the necessary answers for the lawyers, I enclose a questionnaire which you should fill out at this time.

It is necessary that these questions be answered within five days of your receipt of this letter, in order that the jury selection process may proceed at the appointed time. The questionnaire must be signed in the appropriate place. I remind you that jury service is a serious responsibility, and you must answer these questions upon penalty of perjury to the best of your ability and as fully as possible.

The questionnaire must be returned in the return-address envelope attached hereto. All information will be kept strictly confidential.

You should not talk to anyone about anything pertaining to you jury duty from this point until the completion of the trial in which you serve, if you are selected.

JUROR INFORMATION QUESTIONNAIRE

1. Your Full Name:

2. Present Address:

3. Telephone Number: Home ( ) -

Office ( ) -

4. Place of Birth:

5. Parents' Birthplaces:

Father

Mother

6. Date of Birth: and Race:

7. Have you lived at any other address during the last ten years? YES: NO: If YES, what address[es]:

(a) Dates:

(b) Dates:

(c) Dates:

8. Please state the Schools which you have attended:

(a) Grade School: Dates:

(b) Junior High: Dates:

(c) High School: Dates:

(d) College: Dates:

(e) Vocational or Trade School: Dates:

(f) Professional School: Dates:

(g) Graduate School: Dates:

(h) Degrees or Diplomas which you hold:

9. Please state the Schools which your children have attended:

(a) Grade School: Dates:

(b) Junior High: Dates:

(c) High School: Dates:

(d) College: Dates:

(e) Vocational or Trade School: Dates:

(f) Professional School: Dates:

(g) Graduate School: Dates:

(h) Degrees or Diplomas which you hold:

10. What work do you do:

11. Who is your employer:

12. What is your position, and what are your duties in that position:

13. How long have you been with the same employer:

14. For whom else have you worked in the past ten years:

(a) Dates:

(b) Dates:

(c) Dates:

15. Have you ever been in the military service: Branch: ; Dates:

16. Have you ever worked as a volunteer or employee in a law enforcement agency, prison, jail, correctional institution or mental health facility on the local, state or federal level:

When and where:

17. Has a member of your family ever worked as a volunteer or employee in a law enforcement agency, prison, jail, correctional institution or mental health facility on the local, state or federal level:

Who, and what relationship:

When and where:

18. Have you ever appeared as a witness before a Grand Jury or a Justice of the Peace: When and where:

19. Have you ever appeared as a witness in a criminal prosecution: On behalf of the State or the Defendant When and where:

20. Have you ever appeared as a witness in a civil case For the Plaintiff or the Defendant

21. Have you ever served on a Jury before:

Was this a Grand or a Traverse (trial) Jury?

22. Was this a civil case: Did the Jury reach a verdict: If not, please explain:

23. Was this a criminal case:

What was the charge:

Did the Jury reach a verdict: If not, please explain:

24. Have you ever been a party to a legal action: Was it Civil or Criminal

25. If Civil, were you the Plaintiff or the Defendant Was the verdict in your favor: Please Explain:

26. If Criminal, what were the charges involved:

Were you acquitted:

If not, what was the sentence:

27. Have you ever been arrested:

If yes, when:

On what charge: Where:

28. Has any member of your family or any close friend ever been a defendant in a criminal case:

If so, please state your relationship, the charges involved and the outcome:

29. Have you or any member of your family or any close friend ever been the victim of a violent crime? What was the crime:

Was anyone arrested and/or convicted in connection with that crime:

30. What is your:

Political Party Preference:

Religious Affiliation:

31. How often do you attend church:

32. Please list the organizations to which you belong (Social, Fraternal, Service, Charitable, etc.):

33. Please list your Hobbies (Spare time activities):

34. What Newspapers do you read (please state how many times per week with each one):

35. Please list the magazines and periodicals which you read:

36. What are your favorite T.V. programs: 1. 2. 3.

Do you regularly watch the Local News: National News:

37. Are you Married: For how many years: ; Divorced? Widowed? Single?

If you are/were married, what is/was your spouse's:

Name: Occupation:

Educational level:

Political Party Preference:

Religious Affiliation:

38. How many children do you have:

Boys/Age /; /; /

Girls/Age /; /; /

39. What are your children's occupations:

40. Are the people you usually run into in your neighborhood:

All White All Black Both Black and White

41. Is there any other information that you believe might be important for the Court or for the lawyers to know about you as a potential juror: