Juror Qualification Questionnaire



Your name has been drawn by random selection, and you are being considered for jury service in the United States District Court. You must respond to the questionnaire by mail within 10 days of receipt.



Do not ask to be excused by telephone.



You must answer all questions. If you do not fully respond to the questionnaire within 10 days you are liable to be summoned to report at your expense for completion of the questionnaire at this office.



Requesting excuse from jury duty:


70 years of age or older: If you are 70 years of age or older and do not wish to serve as a juror you may request to be excused. Please refer to question number 14 “Grounds for Requesting Excuse.” Darken in the “bubble” next to number 1 (there are 10 “bubbles” in question number 14), write your date of birth in the blank area below question number 14, and sign and date your form.


Deceased - If the person to whom the questionnaire is addressed is deceased, please write “Deceased” in the “Remarks” section on the back of the questionnaire, sign your name and write your relationship to the deceased. You do not need to include a death certificate when you return the questionnaire. Mail the questionnaire back to the Court in the postage-paid envelope.


No longer reside in the Northern District of Alabama
You must complete the questionnaire if you reside in: Bibb, Blount, Calhoun, Cherokee, Clay, Cleburne, Colbert, Cullman, DeKalb, Etowah, Fayette, Franklin, Greene, Jackson, Jefferson, Lamar, Lauderdale, Lawrence, Limestone, Madison, Marion, Marshall, Morgan, Pickens, Saint Clair, Shelby, Sumter, Talladega, Tuscaloosa, Walker or Winston County.


If you no longer reside in one of the above counties, you do NOT need to complete the questionnaire. Write your new address on the questionnaire, sign and date the form and mail it back to the Court.


Full-time student living away from home - You may complete the form for them (sign YOUR name), or forward the form to them for completion.

ALL other excuse requests may be made IF you receive a JUROR SUMMONS from this Court. You may make your request in writing at the time you receive a summons.