___________________________ COUNTY SUPERIOR COURT

JUROR QUESTIONNAIRE SUPPLEMENT




Juror: ____________________________________________________________________

Spouse or Partner: __________________________________________________________

Children: _________________________________________________________________

Parents: __________________________________________________________________



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No _____. Please explain.

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No _____. Please explain.

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I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

DATED: _____________________, 1999




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PRINT NAME JUROR'S SIGNATURE