Form 1.984 - JUROR VOIR DIRE QUESTIONNAIREJURY QUESTIONNAIRE
Instructions to Jurors
You have been selected as a prospective juror. It will aid the court and help shorten the trial of cases if you will answer the questions on this form and return it in the enclosed self-addressed stamped envelope within the next 2 days. Please complete the form in blue or black ink and write as dark and legibly as you can.
1. Name (print)________________________________________ (first)
(middle)
2. Residence address________________________________________3. Years of residence: In Florida________________________________ In this county_____________________________
4. Former residence____________________________5. Marital status: (married, single, divorced, widow, or widower)6. State the highest level of education you completed ________Less than high school | ______________Some college |
_____________High school | ___________________Associate degree |
________________Vocational/Technical school | _______________College degree |
__________________Post graduate degree |
7. Your occupation and employer__________________________8. If you are not now employed, give your last occupation and employer____________________9. If married, name and occupation of husband or wife_______________10. Have you served as a juror before?_____________________11. Have you or any member of your immediate family been a party to any lawsuit?______________________________________________ If so, when and in what court?_________________________________
12. Are you either a close friend of or related to any law enforcement officer? __________________________________________13. Has a claim for personal injuries ever been made against you or any member of your family? ________________________________________ _____________________________________________________
14. Have you or any member of your family ever made any claim for personal injuries? ________________________________________ _____________________
Juror's Signature
Fl. R. Civ. P. form 1.984
Amended by 292 So. 3d 660, effective 1/1/2020; added by 253 So.2d 404, effective 12/31/1971.This form does not have a caption as shown in form 1.901, but should be headed with the name of the court summoning the juror.