Juror Qualification Form Submittal — 25th Judicial District Court

State of Louisiana - Parish of Plaquemines

Juror Qualification Questionnaire

This questionnaire is necessary to determine your qualifications for jury duty. It must be filled out and returned within seven (7) days of receipt. Your jury summons indicates the time and place at the Courthouse to which you should report for jury duty, unless otherwise excused. If you are excused from service by the Court, you will be notified personally.

You MUST call 504-934-6725 after 10:00am on Friday before the jury date for the status of the jury.

Failure to return this completed form may require a personal appearance before the Court.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Social Security Number

Date of Birth

YYYY

Have you served on a jury [not Federal] within the past 2 years?

Are you a citizen of the United States and the State of Louisiana, over the age of 18 years?

Have you been a resident of Plaquemines Parish for the past 12 months?

If not, for how long?

Are you able to read, write, speak and understand the English language?

Are you ineligible to vote because of a felony conviction?

Do you have any problem, such as illness, undue hardship or extreme inconvenience which would affect your ability to serve on a jury?

If yes, please explain

Do you clearly understand you are NOT excused unless the Judge's office notifies you that you have been excused?

Are you 70 years of age or older and wish to claim your exemption?

Juror Number

Date of Jury Service

YYYY

“Jury service is one of the highest duties of citizenship. It is also a very interesting experience and opportunity to learn more about our system of justice. While it may require some adjustment in your normal schedule, we hope that any inconvenience will be minimal and that you will take this opportunity to participate in the vital democratic process. Thank you ”

Dress: Use good judgment. Dress appropriately and in keeping with the dignity of the Court. Shorts and Tank Tops are NOT appropriate.