On-Line Jury Qualification Questionnaire

Jury Information

The questionnaire below is provided as a service to the citizens of Liberty County and should be used for official purposes only. Pursuant to Georgia laws, it is a a criminal offense to use this site for deceptive or fraudulent purposes and persons doing so will be prosecuted.

For information and facts about jury duty, please click here: Juror Information and Facts.

The purpose of this survey is to collect information from you to determine if you are eligible to serve as a trial or grand juror in Liberty County. ONLY PERSONS WHO ARE RESIDENTS OF LIBERTY COUNTY, GEORGIA, ARE ELIGIBLE TO SERVE AS JURORS IN LIBERTY COUNTY. If the information you provide indicates that you are eligible to serve according to Georgia law, a follow-up questionnaire may be sent to you to allow you to provide additional information for the Liberty County Jury Commission.

This survey is divided into the following sections:

Section A - Personal Information
Section B - Juror Exemptions (reasons why you may not be eligible to serve according to law)
Section C - Special Circumstances (for Jury Commission consideration)
Form Submission

Fill out the information in each section as requested. Then at the end of the form supply your E-Mail address, and submit the form. You will receive a confirmation message from us shortly.

To submit a Change of Address, click here.

SECTION A -- Personal Information

What is your name?

Last Name

First Name

Middle Name

Lineage (e.g., Jr., Sr., II, III)

What is your birth date?

Are you a resident of Liberty County?

NoYes If not a resident of Liberty County, please specify the county and state where you reside:

What is your mailing address?

Street/P.O. Box
City
State
Zip Code

What is your race? (Information required by law)

If race is

Other

, please state.

Are you Hispanic/Latino?

NoYes

What is your gender?

What is your phone number(s):

(Home)
(Work)

SECTION B -- Juror Exemptions

The following questions regard information required by Georgia law for every juror. Please answer each question.

1.	Have you ever been convicted of a felony (serious criminal offense)?
	Yes No

2.	If convicted of a felony, when and where?
	Conviction year
	Where convicted (state/county)

3.	If convicted of a felony, were your civil rights ever restored?
	Yes No

SECTION C -- Special Circumstances

The following questions concern circumstances that may affect your jury service.

1.	Check the appropriate block, if applicable?
	I am on active duty status in the United States armed forces. I am the spouse of a person on active duty in the United States armed forces. I am not a legal resident of Liberty County and/or the United States. I have a physical or mental disability that may impair my ability to serve as a juror. I can obtain an affidavit from a doctor/psychiatrist detailing my disability. I do not plan on residing in Liberty County more than two years. I have a child(ren) under the age of six (6) for whom I provide sole and exclusive care and no one else is available to provide care. Serving on jury duty will cause severe financial hardship for my family or me. I do not speak and/or understand the English language well enough to serve as a juror.

2.	Please enter any additional comments concerning any of the questions above or this survey.


3.	What is your E-Mail address?

FORM SUBMISSION

Thank you for taking the time to answer the questions in this Jury Qualification Questionnaire.

To submit your responses, click below on the Submit Form button.

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