New Mexico Forms Library
Decision Information
Rule Set 5 - Rules of Criminal Procedure for the District Courts - cited by 2,161 documents
Rule Set 6 - Rules of Criminal Procedure for the Magistrate Courts - cited by 566 documents
Rule Set 7 - Rules of Criminal Procedure for the Metropolitan Courts - cited by 447 documents
Decision Content
9-513C. Juror questionnaire.
[For use with Rules 5-606, 6-605, 7-605 NMRA]
JUROR QUESTIONNAIRE FORM
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Juror Badge Number: ___________ |
Please answer all questions, 1-20, and SIGN. The Juror Questionnaire will be provided to the attorneys, parties, and judges in all cases you may be selected to hear as a juror. The answers you provide will aid in the process of selecting a jury. If you do not understand a question, please place a question mark (?) next to the question. If you do not have enough room to answer the question, please use the space provided after question 20 or a separate sheet of paper. If there is a question you would rather discuss with the judge and attorneys in private, please indicate with an asterisk (*). Thank you for your cooperation.
1. Legal name and former names: _______________________________________
________________________________________________________________
2. Gender: _________________________________________________________
3. Birth year: _________________
4. What is your race or ethnic background? _______________________________
5. In which neighborhood and/or area do you live? _________________________
Where else have you lived (city, state, country)? _________________________
6. What is your marital status? single _____ married _____
domestic partner _____ separated _____ divorced _____ widowed _____
7. If you are married or in a domestic partnership, please provide spouse’s/partner’s full name and occupation. ___________________________________________
8. Do you have any children or step children? Yes _____ No _____
How many? ______ ages ___________ occupations ______________________
9. Name of current or most recent employer and place of work: ________________
Occupation/job title and duties: _______________________________________
Dates of employment: ______________________________________________
10. How many years of schooling have you completed? ______________________
Highest level completed/degree ______________________________________
Major areas of study: ______________________________________________
11. Do you belong to or participate in any religious, civic, social, union, professional, fraternal, political, or recreational organizations?
Please list all: _____________________________________________________
12. Current political party affiliation: _______________________________________
13. Have you or any member of your immediate family been the victim of a crime?
Yes ____ No ____ If yes, who was the victim? _______________ What crime? _____________ When? ___________ Was an arrest made? Yes _____ No _____
14. Have you ever served as a juror? Yes _____ No _____
(If yes please check) Grand jury ______ Civil ______ Criminal ______
15. Have you or anyone close to you ever sued anyone or been sued? Yes _____ No _____
If yes, please explain: ______________________________________________
16. Have you or an immediate family member ever been an agent, employee, or representative of an insurance company? Yes _____ No _____
17. Have you or an immediate family member been a defendant in a criminal case?
Yes _____ No _____
If yes, please explain: ______________________________________________
18. Have you or any family member ever been employed by a court, law enforcement agency, jail or prison, or any attorney’s office?
Yes _____ No _____
If yes, name of employer: ____________________________________________
19. Do you have a physical or mental disability of which we need to be aware?
Yes ____ No _____
Are you presently taking any medication that may affect your ability to serve as a juror? Yes _____ No _____
If yes, are there any special accommodations, services, or assistance we can provide during your jury service? ______________________________________
20. Is there any reason you could not serve as a juror? Yes _____ No _____ (If you are requesting an excusal or postponement for this reason, you must complete and submit the Request for Postponement, Excusal, or Exemption Form)
If yes, please explain: ______________________________________________
Use this space for any additional comments: __________________________________
______________________________________________________________________
______________________________________________________________________
I SWEAR OR AFFIRM THAT THE INFORMATION I HAVE PROVIDED IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF.
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[Approved by Supreme Court Order No. 17-8300-016, effective December 31, 2017; as amended by Supreme Court Order No. 19-8300-022, effective December 31, 2019.]