JUROR INFORMATION FORM

FULL NAME: *

(Maiden):

ADDRESS: *

CITY: *

ZIP: *

EMAIL: *

PLACE OF BIRTH: *

MARITAL STATUS:

MARRIED:

SINGLE:

WIDOWED:

DIVORCED:

NO. OF CHILDREN: *

OCCUPATION:

YOUR PRESENT EMPLOYER OR PAST EMPLOYER:

BUSINESS ADDRESS:

NAME OF SPOUSE:

SPOUSE'S OCCUPATION:

BUSINESS ADDRESS:

HAVE YOU EVER SERVED ON A CIVIL JURY?

YES

CRIMINAL JURY?

YES

HAVE YOU EVER BEEN PARTY TO A LAWSUIT?

YES

IF YES, WHAT TYPE?

HOME PHONE: *

BUSINESS PHONE: *

CELL PHONE: *

SPOUSE'S BUSINESS PHONE:

EMERGENCY CONTACT NAME: *

EMERGENCY CONTACT PHONE: *

PLEASE CHECK ANY BOX(ES) THAT APPLY TO YOU:

You have any felony conviction, no matter how old it is.

You do not live in Knox County or are not a United States citizen.

You work night shift, are self-employed, or are an independent contractor.

You work night shift, you have been at your current job less than six (6) months, or your employer has fewer than five (5) total employees.

Note: Checking one of these boxes does not mean you are excused from jury service, but you may receive a follow-up call from the court.

Circuit Court
City County Building
400 Main Street
Suite M30
Knoxville, TN 37902
Phone: 865-215-2400
Fax: 865-215-4251

Circuit Court