AO 229(S)
SUPPLEMENTAL JUROR INFORMATION CARD
JUROR NO. JUROR NAME * Privacy Act Information: The Federal Judiciary is required by section 6041 of the Internal Revenue Code to file an information return (From 1099) with the Internal Revenue Service containing the Social Security Number of a juror who receives $600 or more in jury attendance fees during a calendar year. The district court must obtain your Social Security Number in the event it becomes necessary to file an information return for your jury attendance fees. Your Social Security Number will be disclosed by the court only when required by law.
SOC. SEC. NO.*
AO 229(S)
SUPPLEMENTAL JUROR INFORMATION CARD
JUROR NO. JUROR NAME * Privacy Act Information: The Federal Judiciary is required by section 6041 of the Internal Revenue Code to file an information return (From 1099) with the Internal Revenue Service containing the Social Security Number of a juror who receives $600 or more in jury attendance fees during a calendar year. The district court must obtain your Social Security Number in the event it becomes necessary to file an information return for your jury attendance fees. Your Social Security Number will be disclosed by the court only when required by law.
SOC. SEC. NO.*
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