JUROR INFORMATION - County of Marion, MS
To be completed by Juror. If you choose to receive text notifications to report for duty, include your mobile phone number and check the opt-in box.
Juror Form ID#
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Race
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--None--
White
Black
American Indian or Alaska Native
Asian
Hawaiian or Pacific Islander
First Name
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Middle Initial
Last Name
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Sex
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--None--
Female
Male
Age
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Marital Status
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--None--
Married
Single
Divorced
Widowed
Separated
Receive Jury Notifications by Text
Check for yes
Mobile Phone
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Juror Home Address
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Employer
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Juror Home Address City
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Occupation
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Juror Home Address State
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How Long employed (years)
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Juror Home Address Zip
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Level of Education Completed
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--None--
Elementary
Junior High
High School
College Graduate
Graduate School
Above
Juror Mail Address
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Spouse name
Juror Mail Address City
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Spouse Occupation
Juror Mail Address State
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Spouse length employed (years)
Juror Mail Address Zip
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How long have you lived in Marion County? (years)
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Home Phone
If you live outside the city, roundtrip miles from home to Courthouse?
Have you ever served on a Jury?
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--None--
Yes
No
Do you need a certificate showing days served as juror?
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--None--
Yes
No
If served on a Jury, what type?
Criminal
Civil
Grand Jury
Have you ever been accused, complainant or witness in a criminal case?
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--None--
Yes
No
Have you ever been a defendant, plaintiff or witness in a civil case?
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--None--
Yes
No
I hereby certify that the above information is true and correct and I have personally completed this form as required by $ 13-5-1 MCA of 1972 (by submitting this form electronically you confirm your agreement)