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Jury Service Questionnaire

Please correct the field(s) marked in red below:

Clerk of District Court

200 West Broadway
Missoula, MT 59802
Phone: (406) 258-4780 Email: dcjury@missoulacounty.us

Questionnaire as to Qualification for Jury Service

Please fill out this form as thoroughly and accurately as possible.

1
Please enter your name:
 *
Please enter your name:
2
Juror Number
 *
3
Address:
 *
Address:
4
Please state the round trip mileage from your home to the courthouse:
 *
5
Telephone Numbers
 *
Telephone Numbers
6
Email Address:
7
How long have you resided there?
 *
How long have you resided there?
8
Marital Status:
 *
Marital Status:
9
Age:
 *
10
Sex
 *
Sex
11
Do you have children?
 *
Do you have children?
12
Education:
13
Are you employed at present?
 *
Are you employed at present?
14
Employer Information:
Employer Information:
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