Online Juror Qualification Form
Online Juror Qualification Form

For Juror Qualification, please fill completely fill out the form on this page. If you would prefer, you may print the form from the link below for mailing. 
Click here to download Summons Form to be printed and mailed...Click here to download Summons Form to be printed and mailed...

ONLINE JUROR QUALIFICATION FORM

ANSWER EACH QUESTION BELOW UNDER PENALTY OF PERJURY.

Are you a citizen of the United States? Yes
No
Are you currently a resident of Davidson County? Yes
No
Are you 18 years of age or older? Yes
No
Do you read, write, speak and understand the English language? Yes
No
If another person completed this form, please provide their name address and the reason.
Have you ever been convicted or pled guilty to any felony offense, perjury or subornation of perjury? Yes
No
Do you have a physical or mental disability that would interfere with or prevent you from serving as a juror? If "Yes" please explain. See Request to be Excused/Postponed section below. Yes
No

Contact Information
First Name:       Middle Initial:
Last Name:   
Date of Birth:
How is your name listed on the summons/letter?
Street Address:
City:     State:
Zip:
Phone:
Your E-mail Address:
Employer:
Your Occupation:
Work Phone:
Your Spouse's Occupation:

Request to be Excused/Postponed

Please use the space provided below to state your reason to be deferred or excused from jury service. Jurors will only be excused if serving will cause and undue, extreme physical or financial hardship. If you wish to assert such a hardship, explain the nature of your hardship and enclose an affidavit, income tax returns, medical statement or any other documentation which may be relevant to your request. Failure to provide satisfactory documentation will result in the denial of your request. If you do not receive further notice, your request has been granted.

If you need to be deferred, please list two (2) separate weeks in which you could serve. If your request is granted, you will receive confirmation and instructions by mail.