Free Proposed Voir Dire - District Court of Colorado - Colorado

Case 1:00-cr-00531-WYD

Document 1988-2

Filed 11/02/2006

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IN THE UNITED STATES DISTRICT COURT FOR THE DISTRICT OF COLORADO

Criminal Action No. 00-CR-531D UNITED STATES OF AMERICA, Plaintiff, v. WILLIAM CONCEPCION SABLAN Defendant.

JUROR QUESTIONNAIRE
TO THE PROSPECTIVE JUROR: You have been summoned as a prospective juror in the case of United States of America v. William Sablan. This criminal trial will take place at the U.S. Courthouse at 901 19th Street, Denver, Colorado. Mr. Sablan is charged with Murder in the First Degree of Joey Estrella. Mr. Sablan has pled not guilty and is presumed to be innocent. Murder in the First Degree is defined under federal law as the unlawful killing of a human being with malice aforethought. Murder in the First Degree is a willful, deliberate, malicious, and premeditated killing. The events underlying the charged offense are alleged to have occurred on October 10, 1999 at the United States Penitentiary in Florence, Colorado. On October 10, 1999, William Sablan and Joey Estrella were both inmates at the United States Penitentiary in Florence. The trial is scheduled to start on or about January 22, 2007 and it is expected to last approximately ______ weeks. The jury selection process is expected to take about fourteen (14)

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days. Those selected as members of the jury will live at home and have their evenings, weekends, and generally one weekday per week free. AS A POTENTIAL JUROR ARE REQUIRED BY LAW TO COMPLETE THIS QUESTIONNAIRE REGARDLESS OF ANY PROBLEMS THAT YOU MAY HAVE SERVING AS A JUROR IN THIS CASE. The purpose of this questionnaire is to save time and avoid jurors having to sit and wait before they answer these or similar questions in person. The information which you give in your answers to this questionnaire will be used only by the Court and the parties to select a qualified jury. After a jury has been selected, all copies of your response to this questionnaire will be returned to the Clerk of the Court and kept in confidence, under seal. The attorneys are under orders to maintain the confidentiality of any information they learn in the course of reviewing this questionnaire. The purpose of these questions is not to ask unnecessarily about your personal matters. It is solely to determine whether a prospective juror can decide this criminal case fairly, objectively, and impartially. Answer each question below as completely and as accurately as you reasonably can. Remember that there are no right or wrong answers, only complete and incomplete answers. The only thing that matters is that your answers are truthful. Your

complete written answers will save a great deal of time for the Judge for the lawyers, and for you. Print your answers and use ink only. If your answers are illegible, you may be required to re-copy your answers. Fill out the entire questionnaire. Do not leave any questions blank. If a question does not apply to you in any way, write "N/A" rather than leaving the form blank. If you cannot answer a question because you do not understand it, write"Do not understand" in the

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space after the question. If you cannot answer a question because you do not know the answer, write "Do not know" in the space after the question. Do not write anything on the back of any page. If at any point in this questionnaire you need more space to complete your answer, continue your answer on the blank sheets of paper provided at the end of this questionnaire. Be sure to indicate on the blank page the number of the question you are answering. What is needed is your very best, honest effort to answer the questions contained in this questionnaire. You must answer the questions by yourself. Do not discuss with anyone any question or answer you give on this questionnaire. You are expected to sign your questionnaire, and your answers will be given the same effect as a statement given to the Court and under oath. When the jury selection process begins in court, you may be asked some follow-up questions based on one or more of your answers to the questionnaire. If there are matters in your completed Questionnaire that you believe are personal and confidential, write "Private" next to your answer. You will have the opportunity to request to discuss them privately with the Court and counsel. In addition, now that you are a prospective juror, you MUST follow the instructions listed below until you have been excused from further service in this case. DO NOT read or listen to any news accounts whether in a newspaper, on the television, or on the radio concerning this case. DO NOT at any time discuss this case with anyone, including your friends, family members, or other members of this jury panel. DO NOT conduct any research or investigation regarding this case, the alleged facts of the case, or the law that may apply in

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this case, including but not limited to internet research or investigation. DO NOT let anyone, including friends, family members, court personnel, parties in this case, or persons involved in the case, talk to you about your views or any aspect of this case except officially in the courtroom. Thank you for your cooperation with these instructions and for your careful and honest responses to the questionnaire. Your forthright and full cooperation is of vital importance to the Court and the parties. _____________________________________ Wiley Y. Daniel United States District Judge District of Colorado

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_______________________ JUROR NUMBER

PLEASE PRINT LEGIBLY
Note: if you need more space to complete any of your answers, there are blank pages at the end of this questionnaire provided for your use.

I. 1.

PRELIMINARY MATTERS Are you able to read and understand the English language? Yes _____ With difficulty _____ No _____

2.

Are you able to write and understand the English language? Yes _____ With difficulty _____ No _____

3.

Prior to today, have you asked to be excused from this jury panel? Yes (___) No (___) If yes, on what basis? __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

4.

How is your hearing? _____ No problems at all _____ Have difficulty hearing _____ Have problems, but they are corrected with a hearing aid

5.

How is your eyesight? _____ No problems at all _____ Have difficulty seeing _____ Have problems, but they are corrected by glasses or contact lenses

6.

Do you know any of the other prospective jurors on this case? Yes (___) No (___) If yes, please identify which juror(s) you know and how you know them: __________________________________________________________________ __________________________________________________________________

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7.

Do you have any moral, religious, or ethical beliefs that prevent you from sitting in judgment of another person? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

8.

Is there any reason that you believe would cause you to be unable to serve as a juror for ___ weeks beginning January 22, 2007? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

II.

BACKGROUND INFORMATION

[ Note: If you are living with someone, please provide information about your "significant other" or "domestic partner", on every question where information is requested about a "spouse"]

9.

Your full name: ____________________________________________________

10.

Have you been known by any other name(s)? Yes (___) No (___) __________________________________________________________________ (List other name(s) used)

11.

Age: _________

Place of Birth: ___________________________________

12.

Present marital status: Single and never married (___) Married (___) # of years: _______________ Separated (___) # of years: _______________ Divorced (___) # of years: _______________ Living with significant other (___) # of years: _______________ Widow or Widower (___) # of years: _______________ __________________________________________________________________ (List Spouse's or significant other's name)

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13.

Your city and county of residence: _____________________________________

14. How long have you lived at your current address? _________________________

15.

Please list the city and state of any residence that you have had over the last 10 years: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

16. How many people live in your household? __________ If persons other than your spouse and children live with you, describe their relationship to you: __________________________________________________________________

17.

Your employer: ____________________________________________________ Length of employment:_________________________________________ Job Duties: __________________________________________________

18.

Do you supervise others at your place of employment? Yes (___)

No (___)

19.

Do you own any portion of the business at which you work? Yes (___) No (___)

20.

How are you paid? (Check all that apply): Hourly ____ Daily ____ Overtime ____ Salary ____ Commission/bonus ___

21.

List jobs you have held in the past twenty (20) years with your primary responsibilities:
TYPE OF EMPLOYMENT POSITION DATES REASON FOR LEAVING

a. b. c. d. e.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

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22.

If not currently employed, please describe other responsibilities that you have (such as childcare, school, etc.): __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

23.

Provide the following information for your spouse: Employer: ____________________________________________________ Length of employment: ______________________________________________ Job Duties: ________________________________________________________

24.

List jobs your spouse has held in the past including their primary area of responsibility:
TYPE OF EMPLOYMENT POSITION DATES REASON FOR LEAVING

a.____________________________________________________________ b.____________________________________________________________ c.____________________________________________________________ d. ____________________________________________________________ e.____________________________________________________________

25.

If your spouse is not currently employed, please describe other responsibilities (such as childcare, school, etc.): __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

26.

Do you have children or stepchildren? Yes (___) No (___) If the answer is yes, for each child and/or step child, please provide the following information:
GENDER AGE HIGHEST GRADE COMPLETED OCCUPATION

a. b. c. d. e. f.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

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27.

Check the highest level of education attained by you and your spouse: You Spouse a. Grade school or less ________ ________ b. Some high school ________ ________ c. High school graduate ________ ________ d. Technical or business school ________ ________ e. Some college ________ ________ f. College degree (and describe area) ________ ________ g. Graduate degree (and describe area) ________ ________

28.

Check to indicate whether you or your spouse has taken any courses or received any training in any of the following fields: Spouse You a. Psychology / counseling ________ ________ b. Sociology / social work ________ ________ c. Law (criminal / constitutional law) ________ ________ d. Criminal justice (corrections / police work investigation ) ________ ________ e. Medicine (including EMT) ________ ________ f. Education / Child development ________ ________

29.

Describe any special training or skill you have: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

30.

Have you or any member of your family ever been enlisted in any branch of the armed forces of the United States of America (including the military reserves)? Yes (___) No (___) a. b. c. d. If you served in the armed forces, what were the approximate dates of your service? ________________________________________________ What was your discharge status?_________________________________ What branch of the service were you in? ____________________________ Were you in active combat? Yes (___) No (___) If "Yes", where? ______________________________________________

31.

What is your race or ethnic background? ________________________________

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32.

William Sablan is from the Island of Saipan. Saipan is part of the Commonwealth of the Northern Mariana Islands. The Commonwealth of the Northern Mariana Islands is a self governing commonwealth in political union with and under the sovereignty of the United States. The Mariana Islands are located in the western Pacific Ocean. Mr. Sablan is a Chamorro. Chamorroans are an ethic group indigenous to the Mariana Islands. Do you have any familiarity or experience with or exposure to the Island of Saipan, the Commonwealth of the Northern Mariana Islands or Chamorro culture? Yes (___) No (___) If yes, please explain the extent and nature of you familiarity, experience or exposure: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

33.

Please list the names of all organizations to which your or your spouse belong including clubs, unions, church or religious organizations, societies, fraternal organizations, political, professional, community, social service, special interest, or recreational groups. (Indicate any office or leadership positions you have held in any of these groups): __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

34.

What is your main source of news and information? (Check all that apply) TV ____ Newspapers ____ Radio ____ Magazines ____ Internet ____

35.

What newspapers or magazines to you read regularly? __________________________________________________________________ __________________________________________________________________

36.

About how many hours per day do you watch television? ___________________

37.

List the three television programs you watch most frequently: a. ______________________________________________________________ b. ______________________________________________________________ c. ______________________________________________________________

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38.

Do you regularly watch any television programs about law, law enforcement, courts, crime, criminal investigations or mystery Yes (___) No (___) If "Yes", what shows do you watch? __________________________________________________________________ __________________________________________________________________

39.

Do you make a conscious attempt to avoid seeing films, television programs, or photographs that depict graphic violence? Yes (___) No (___)

40.

What type of books do you like to read? __________________________________________________________________ __________________________________________________________________

41.

Are you a registered voter?

Yes (___) No (___)

42.

Check your political party affiliation, if any (please check one): _____ Democrat _____ Republican _____ Independent _____ Libertarian _____ Other ____________________

43.

What are you hobbies, favorite recreations or pastimes? __________________________________________________________________

44.

What are your spouse's hobbies, favorite recreations or pastimes? __________________________________________________________________

45.

List any bumper stickers or decals on any vehicle in your household: __________________________________________________________________

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46.

Have you, your spouse, any members of your family or any friends ever worked as, worked for, or worked with psychiatrist, psychologist, therapist, or mental health professional or in a mental health facility? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

47.

Have you, your spouse, any members of your family or any close friends ever sought the services of a psychiatrist, psychologist, therapist, mental health professional or mental health facility? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

III.

EXPERIENCE WITH LAW, LAW ENFORCEMENT, THE COURTS, AND THE LEGAL SYSTEM Have you ever served on a jury in a criminal trial in either federal or state court? Yes (___) No (___) If yes: How many times have you served as a juror? _______________________ For each jury service: a. What was the charge or alleged crime involved: ______________________________________________________ b. Was the jury able to reach a verdict: Yes (___) No (___) c. What was the verdict? ___________________________________ d. Did the jury set punishment? ______________________________ e. Were you the foreperson? Yes (___) No (___) f. Was there anything about your jury service that left you disappointed or dissatisfied with the criminal justice system: Yes (___) No (___) If yes, please explain: ______________________________________________________ ______________________________________________________

48.

NOTE:

If you have served on more than one jury, please use additional space at the end of this questionnaire.

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49.

Have you, any members of your family, or any of your friends, ever been a victim of any kind of crime, whether it was reported to law enforcement authorities or not? Yes (___) No (___) If yes:
RELATIONSHIP OF PERSON TO YOU TYPE OF CRIME ANYONE ARRESTED CASE OUTCOME

a. b. c. d. e. f.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

50.

Have you, any members of your family, or any of your friends, ever been a witness to any kind of crime? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

51.

Do you know anyone who has been injured or died as a result of a crime? Yes (___) No (___) If yes, please explain the circumstances and the person's relationship to you: __________________________________________________________________ __________________________________________________________________

52.

Have you ever been accused of, charged with, or convicted of any crime, other than a minor traffic violation? Yes (___) No (___) If yes, please explain including the date, the charge, who brought the charge, and the outcome: __________________________________________________________________ __________________________________________________________________

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53.

Has any member of your family, or a friend, ever been accused of, charged with, or convicted of any crime, other than a minor traffic violation? Yes (___) No (___) If yes, please explain including the relationship of the person to you, the date, the charge, who brought the charge, and the outcome: __________________________________________________________________ __________________________________________________________________

54.

Have you or anyone you know ever served time in a jail or penitentiary? Yes (___) No (___) If yes, please provide details: __________________________________________________________________ __________________________________________________________________

55.

Do you belong to or support any neighborhood crime watch group or organization? Yes (___) No (___)

56.

Have you, any members of your family or any friends, ever been employed by, made any application for employment, or performed volunteer work with any law enforcement agency, investigative agency, or private security agency such as: a federal, state or local police department, the Federal Bureau of Investigation (FBI), the Colorado Bureau of Investigation (CBI), the Bureau of Alcohol, Tobacco and Firearms (ATF), Drug Enforcement Agency (DEA), the U.S. Marshal, District Attorney Offices, Department of Justice, United States Attorney's Offices, federal or state probation or parole offices, or any other local, state or federal agency or private security force? Yes (___) No (___) If yes, indicate yourself or the relationship to the person employed, the law enforcement agency, the period of time employed, if known, and a general description of the job duties, if known:
RELATIONSHIP ORGANIZATION TIME EMPLOYED DUTIES

a. b. c. d.

____________________________________________________________ ____________________________________________________________ ____________________________________________________________ ____________________________________________________________

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57.

Have you or anyone close to you, ever worked in any capacity in any federal or state, or local prison, jail, detention center, Department of Corrections, or Bureau of Prisons? Yes (___) No (___) If yes, please provide details: __________________________________________________________________ __________________________________________________________________

58.

What is your opinion of attorneys who prosecute people accused of crimes? __________________________________________________________________ __________________________________________________________________

59.

What is your opinion of attorneys who defend people accused of crimes? __________________________________________________________________ __________________________________________________________________

IV. 60.

OPINIONS ABOUT EVIDENCE The evidence in this case might include testimony and photographs that describe and depict severe injuries. Does the possibility of exposure to that type of evidence affect your ability to decide this case fairly and impartially on the evidence presented and the law as stated by the judge? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

61.

The evidence in this case might include testimony from mental health professionals and experts. Do you believe it is appropriate to consider evidence of mental illness and will you have any problem or reservation with considering such evidence? Yes (___) No (___) Please explain your answer: __________________________________________________________________ __________________________________________________________________

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V.

DEATH PENALTY CONSIDERATION OF THE DEATH PENALTY The following questions concern your feelings, attitudes, opinions, and beliefs about the

death penalty. The court is asking these questions regarding your feelings about the death penalty because persons convicted of the charge of first degree murder are punished in one of two ways: by a sentence of life in prison with no possibility of release or by the death penalty. Therefore, the court must know whether you could be fair to both the prosecution and to Mr. Sablan in a case in which the death penalty is a possible punishment. By asking these questions the court is not suggesting that the jury will return any particular verdict, because the court does not know whether you will find Mr. Sablan guilty or not guilty of first degree murder. That you are being asked questions about the death penalty does not mean that Mr. Sablan is presumed to be guilty. You must remember that Mr. Sablan is presumed to be innocent and the government bears the burden of proving his guilt beyond a reasonable doubt. There could be two phases in the trial of this case. In the first part of the trial, the jury will hear evidence and then decide whether or not Mr. Sablan is guilty of the crime charged. If the jury finds that the government has proved beyond a reasonable doubt that he is guilty of a crime for which the death penalty is a possible punishment, then there will be a sentencing hearing in which the same jury will hear additional evidence and then decide whether or not he should be sentenced to death or to life imprisonment without the possibility of release. During a sentencing hearing, the Government has the opportunity to present information as to certain things referred to in the law as aggravating factors, or the circumstances that arguably support the imposition of the death penalty. During a sentencing hearing, Mr. Sablan will have the opportunity to present information of what are referred to as mitigating factors, or

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the circumstance about the crime or about the individual that arguably suggest that the death penalty is not appropriate in this case. Mitigating circumstances need not constitute a complete defense to the charges, such as self-defense or insanity. Mitigating circumstances are facts about the defendant or the crime that would cause you to believe that a sentence of death is not appropriate. Before each juror could vote to impose the death penalty, each juror would have to be persuaded beyond a reasonable doubt that the defendant had the requisite state of mind when he engaged in the crime. Each juror must also find that at least one or more of the specific aggravating factors set forth in the death penalty statute and identified by the Government exists. Each juror must consider any information submitted by the defendant in mitigation of sentence, as well as consider any mitigation that individual juror determines exists within the entire case. Moreover, before each juror could vote to impose the death penalty, each juror would also have to be persuaded that the aggravating factors that the jury unanimously found to exist sufficiently outweighed any mitigating factors found by that individual juror. Even if a juror did not find any mitigating factors, that juror would still have to be persuaded that a sentence of death is the appropriate sentence. No juror is ever required to return a sentence of death, even after a determination that aggravating factors may outweigh mitigating factor(s). Each juror must come to his or her own individual decision as to whether to impose the death penalty. To impose the death penalty, all jurors individually must agree to impose the death penalty. If all the jurors do not unanimously agree on a sentence, the court must impose a sentence of life imprisonment without possibility of release.

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In sum, the jury is never required to impose a sentence of death upon any defendant. You should know, however, that if each juror decides to impose the death penalty on William Sablan, this Court is required to sentence that defendant to death. If the jury decides to impose a sentence of life imprisonment without the possibility of release, the Court is required to impose that sentence. In other words, the Court cannot change your decision. Obviously, this is only an overview of the law applicable to a jury's consideration of the death penalty. If this case were to require a sentencing hearing ­ and remember Mr. Sablan is presumed innocent of the charges that have been brought against him ­ the Court will instruct the jury in more detail about its duties.

62.

Please describe, in your own words, your feelings about the death penalty and the strength of your feelings about the death penalty. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

63.

What purpose, if any, do you think the death penalty serves in our society? __________________________________________________________________ __________________________________________________________________

64.

Have your opinions and feelings about the death penalty ever been different than they are now? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

65.

Where one person intentionally kills another person: ____ The death penalty is always justified ____ The death penalty may or may not be justified depending on the circumstances of the case ____ The death penalty is never justified

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66.

Anyone who commits a murder should get the death penalty: ____ Strongly Agree ____ Agree Somewhat ____ Disagree Somewhat ____ Strongly Disagree

67.

A person's background does not matter when it comes to whether or not he should be sentenced to death for a murder: ____ Strongly Agree ____ Agree Somewhat ____ Disagree Somewhat ____ Strongly Disagree

68.

Whether a person suffers from mental illness does not matter when it comes to whether or not he should be sentenced to death for a murder: ____ Strongly Agree ____ Agree Somewhat ____ Disagree Somewhat ____ Strongly Disagree

69.

How do you feel about the concept of "an eye for an eye" and a "life for a life" as a punishment for the crime of murder? Please explain: __________________________________________________________________ __________________________________________________________________

70.

Do you believe there are certain crimes for which a person convicted of committing that crime should ALWAYS receive a death sentence? Yes (___) No (___) If yes, which crimes: __________________________________________________________________ __________________________________________________________________

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71.

Can a sentence of life imprisonment without possibility of release be an appropriate punishment for someone who intentionally commits murder? Yes (___) No (___) Please explain your answer: __________________________________________________________________ __________________________________________________________________

72.

Would you be able to consider the evidence in support of all aggravating and mitigating factors, based upon the facts of the case and the judge's instruction on the law, and make an appropriate decision as to a sentence of death or life imprisonment? Yes (___) No (___)

VI. 73.

CONCLUSION The following are statements of law. Please state your personal belief of the following statements of law. Mr. Sablan is presumed to be innocent. _____ Agree strongly _____ Agree _____ No opinion _____ Disagree _____ Disagree strongly regarding each

The prosecution's burden is to prove the charges against Mr. Sablan beyond a reasonable doubt. If the prosecution fails to do so, you must find Mr. Sablan not guilty. _____ Agree strongly _____ Agree _____ No opinion _____ Disagree _____ Disagree strongly

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Mr. Sablan has been charged by a complaint [called an "Indictment"] which has been filed by the United States Attorney. The fact that Mr. Sablan was charged is not evidence of his guilt, and no negative inference may be drawn from the fact that he was charged. _____ Agree strongly _____ Agree _____ No opinion _____ Disagree _____ Disagree strongly

The death penalty is a potential sentence in this case. The fact that the death penalty is a possibility does not make it any more likely that Mr. Sablan is guilty of first degree murder. _____ Agree strongly _____ Agree _____ No opinion _____ Disagree _____ Disagree strongly

Mr. Sablan need not present any evidence in this case, and he also need not testify if he chooses not to do so. If Mr. Sablan chooses not to testify, you may not draw any inferences from that decision, and it may not be considered as any evidence of guilt. _____ Agree strongly _____ Agree _____ No opinion _____ Disagree _____ Disagree strongly

74.

The judge in this case is Judge Wiley Daniel. Do you know, or have you had any social or professional contact with Judge Daniel? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

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75.

The following attorneys are involved in this case. Do you know, or have you had any social or professional contact with any of them? Brenda Taylor Phil Brimmer Pat Burke Nathan Chambers Susan Foreman Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

76.

Attached to this Questionnaire is a list of persons who may be witnesses in this case. Please place a check mark next to the name of any person that you know or may know.

77.

Do you have any concern about the reactions of family members, friends, neighbors, or other persons to your decisions regarding the verdict or sentence if you serve as a juror in this case? Yes (___) No (___) If yes, please explain: __________________________________________________________________ __________________________________________________________________

78

As a result of having been asked to fill out this questionnaire, have you now formed any opinions about this case? Yes (___) No (___) Please explain your answer: __________________________________________________________________ __________________________________________________________________

79.

Please list below anything not previously covered by this Questionnaire that you believe the Court and the lawyers would want to know about yourself and that you think may be important with reference to your ability to serve as a juror in this criminal case. __________________________________________________________________ __________________________________________________________________ __________________________________________________________________ __________________________________________________________________

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80.

Is there any matter you would prefer to discuss privately? Yes (___) No (___) If yes, please indicate here the numbers of the question or questions that concern you: __________________________________________________________________ __________________________________________________________________

CERTIFICATION
I hereby certify under the penalty of perjury that I have answered all of the above questions in this Juror Questionnaire to the best of my ability, by myself, and truthfully. _________________________ Signature _________________________ Print your name here __________ Date

Additional Answer Sheets (please make reference to the question being answered) _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ 23

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_________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ ________________________________________________________________________

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