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Official Jury Summons
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This is for the convenience of our County Residents who need to take a qualification and/or exemption. Please fill out the summons and click submit.
1111 E. Yellowjacket Ln., Ste. #101
Rockwall County, TX 75087
IMPORTANT - PLEASE READ
Dear Prospective Juror: YOU ARE HEREBY SUMMONED TO APPEAR FOR JURY DUTY SERVICE ON THE DATE AND TIME SPECIFIED BELOW:
Call (972) 204-6601 after 5:00 pm on the last working date prior to your scheduled appearance for recorded instructions.
Date of Appearance
Please carefully read all information.
Answer all questions below. Bring entire summons with you to court.
Please print legibly. You are to appear promptly as instructed by this summons. If you have a special need or disability you are encouraged to notify the court immediately concerning request for reasonable accommodation.
THE FOLLOWING "JUROR QUESTIONNAIRE" IS MANDATED BY GOVERNMENT CODE, SECTION 62.0123.
Your answers are CONFIDENTIAL and may be disclosed only to the judge, court personnel, the litigant, and the litigant's attorney.
Are you a U.S. Citizen?
Race (required by State Law)
Date of Birth
Mailing Address (if different from home)
County of Residence
Have you ever served on a civil jury?
Have you ever served on a criminal jury?
Current Martial Status
Number of Children
Ranges of Age (from ___ years to ___ years)
Please check the highest level of education completed?
Did not receive H.S, Diploma?
2 yr. College
4 yr. College
AFFIDAVIT AND CERTIFICATION OF EXEMPTION OR DISQUALIFICATION FORM
IF CLAIMING AN EXEMPTION OR DISQUALIFICATION, CHECK THE CORRESPONDING BOX.
(Gov't Code, Section 62.106)
be exempted from jury service if (select one that applies):
You are over 70 years of age
You have legal custody of a child or children younger than 12 years of age and service on the jury would require leaving the child or children without adequate supervision
You are a student at a public or private high school
You are enrolled and in actual attendance at an institution of higher education
You are an officer or an employee of the senate, the house of representatives, or any department, commission, board, office, or other agency in the legislative branch of state government
You are the primary caretaker of a person who is unable to care for himself or herself (this exemption does not apply if you are a primary caretaker only in your capacity as a health care worker.)
You are a member of the United States military forvces serving on active duty and deployed to a location away from your home station and out of your county of residence
I am not claiming an exemption, I am claiming a disqualification
(Gov't Code, Section 62.102)
To be qualified to serve as a juror you must (select one disqualification):
Be at least 18 years of age
Be a citizen of the United States
Be a resident of this state and of the county in which you are to serve as a juror
Be qualified under the Constitution and laws to vote in the county in which you are to serve as a juror (Note: You do not have to be registered to vote to be qualified to vote)
Be able to read and write
Not have served as a juror for six days during the preceding three months in the county court or during the preceding six months in the district court; and
Not have been convicted of, or be under indictment or other legal accusation for, misdemeanor theft or a felony
I am not claiming a disqualification, I am claiming an exemption
*You are not required to claim an exemption. It is your choice.
BUSINESS REASONS ARE NOT LAWFUL EXCUSES
I, do hereby certify under penalty of perjury that I am
Exempt because of the reason(s) marked above
Disqualified because of the reason(s) marked above
If claiming an exemption for person over 70 years of age please check if this exemption is
If you need to contact us for information other than exemptions and qualifications,
I CERTIFY THAT ALL ANSWERS ARE TRUE AND CORRECT. If yes, then submit this form.
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