Fairfield County Municipal Court
PH: 740-687-6621
FAX: 740-681-5014
136 West Main Street
Post Office Box 2390
Lancaster, Ohio 43130
Daily Court Hours:
8:00am - 4:00pm
Monday-Friday
Valeda A. Slone - Clerk of Court

Juror Information Sheet

First Name *
Last Name *
Street Address*
(Address Line 2)
City*
State*
Zip Code*
Juror Number*
Date of Birth*
Age
Daytime Phone*
Home Phone*
Marital Status
v
Spouse's Name
Number of Children
Children's Ages (if under 18)
Your Employer
Duties of Employment
Spouse's Employer
Have you ever been a Defendant or Plaintiff in a civil or criminal action?
Are you related to any police officers or people in law enforcement?
Have you ever served on a jury before?
Have you, or members of your family, been involved in any criminal proceedings?
Are you claiming an exemption from jury duty?


Please enter vacation/out of town dates during the 2 month jury period (the Court will try to accommodate). If additional proof is needed, you will be notified by phone. If you are granted a partial excuse, you will be notified by mail:

Date 1 From:
v
Date 1 To:
v
Date 2 From:
v
Date 2 To:
v

Anti-Spam Measure *
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