Juror Qualification Questionnaire

Juror Qualification Questionnaire
County of McKean 
Telephone 814-887-3444
Online Juror Qualification Questionnaire

This is NOT a summons to Jury Duty

Jury service is a legal obligation for every citizen.  Excusals are strictly reviewed and only granted when there is definite need due to hardship or other limited legitimate basis.  Do you believe that there is a legitimate basis to excuse you from jury service – or – serving would be a great hardship for you?  If the answer is yes please explain below.  You are not automatically excused by presenting a claim here.  If you receive a summons to appear in the future you must still appear.

1. Are you an American Citizen?  

2. Are you a resident of McKean County? 
     If yes - Name of Municipality (City or Twp or Boro) 

3. Are you able to read, write, speak and understand English? 

4. Are you 18 years of age or over? 
     If you are over the age of 75, you may be excused by checking this box 

5. If you have a disability or physical condition which would impair your capacity to serve as a juror, please state:
(You must provide a signed statement from doctor or medical provider.)   

6. Have you ever been convicted of a crime that permits maximum punishment by imprisonment for more than one year and have not been pardoned? 

Note: This refers to the maximum permissible sentence for such a crime and not to the actual sentence received
If Yes, State the crime, sentence imposed and the year of the sentence 

7. Are you in active service in the armed forces of the United States or of the Pennsylvania National Guard? 

8. Have you served on Jury Duty in McKean County or any other court within the past (12) Months?  

9. Occupation: 
Name and Address of Employer: 
If retired – former occupation: 

10. Did you require assistance to complete this questionnaire?  
If yes – please explain: 

I declare under penalty of perjury, the forgoing answers are true and correct.  

* Pleae Note the name
on mailing, if incorrect
City or Town:
State or Province:
Zip or Postal Code:
Cell Phone: