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PLEASE COMPLETE THE JUROR INFORMATION FORM AND BRING OR MAIL TO THE CLERK OF COURT’S OFFICE within ten (10) days OF RECEIVING THIS SUMMONS. ADDRESS: TELEPHONE: [PHONE REDACTED] JUDY ODOM CLERK OF SUPERIOR COURT UNION COUNTY COURT HOUSE 65 COURTHOUSE STREET BLAIRSVILLE, GA 30512 JUROR INFORMATION FORM The information requested is that generally asked by Attorneys in selecting a jury. (CIRCLE YOUR ANSWERS) Date to Appear: Home Phone Business Phone Reporting Time: Summons No.: Place of Birth Date of Birth Juror ID: JUROR Marital Status: Name of Spouse Name: Married Widow(er) Age of Spouse: Mailing Address: (PLEASE FILL IN) Single Separated # of Children: What is your type of Work? # of Years Worked There? Cell Phone: What is spouse's type of work? # of Years Worked There? How long have you lived in UNION County? Your Present Employer If retired, please specify previous employer. Have you or a member of your immediate family been a party If yes, when and in what court? to a law suit? Yes No Spouse's Employer If retired, please specify previous employer. Has a claim of personal injury ever been made against you? Are you related by blood or marriage to any person in Law Enforcement? Yes No Yes No Have you ever served as a Juror? If, yes, what type of case? Have you ever been a victim of a crime? If yes, when and what type of crime? Yes No Criminal Civil Both Yes No