Juror Qualification {4-602B}

4-602B. Juror qualification.[For use with Rules 1-047, 2-603, 3-603 NMRA]JUROR QUALIFICATION FORMJuror Badge Number: Dear Prospective Juror: Please answer each of the following questions completely. The contact information you providewill by used only by court employees and shall not be made available to the attorneys or partiesin the cases that you may be selected to hear as juror.Estos formularios est341n disponibles en espa361ol en (insert web address). Sineccesita m341s ayuda en espa361ol, llame al n372mero telef363nico indicado en la primera p341gina delcitatorio para prestar servicio como jurado. Name as it appears on the summons: Legal name: Mailing address: Home address (if different): City: State: Zip: Phone numbers: Home: Business: Ext: Cell: E-mail: 1.Do you live more than forty (40) round-trip miles from your home to the courthouse?Yes No If yes, what is your round-trip mileage? Would you like to be compensated for milage? Yes No 2.Are you employed by the public schools, local government, or the State of New Mexico?(Note: these public employees cannot be compensated by the court for their jury service.) Yes No 3.Of which New Mexico county are you a resident? 4.Are you a United States citizen? Yes No If no, country of citizenship: 5.Will you need an interpreter? Yes No If yes, which language? 6.Have you ever been convicted of a felony? Yes No American LegalNet, Inc. www.FormsWorkFlow.com a.If yes, please explain: b.If yes, have you completed all conditions of parole or probation? Yes No c.If yes, please enclose a copy of one of the following: Certificate or letter of completion issued by the Department of Correctionsof New Mexico, or another state. Certificate or letter of pardon from the Governor of New Mexico, or another state. SELECT ONE:I am available to serve for the dates listed on my summons (skip to signature, sign andreturn form).I am requesting a postponement for the reasons noted below until the following date: (jury service may be postponed for up to six (6) months).I am requesting to be excused or exempted for the reasons noted below. I am submittingthe required documents. REQUEST FOR POSTPONEMENT, EXCUSAL, OR EXEMPTION If your jury service is scheduled for a date that conflicts with your schedule, please request apostponement for a more convenient time. There are NO AUTOMATIC EXEMPTIONS. All exemptions must be requested, includingexemptions based on age or prior jury service. ALL situations will be considered on a case-by-case basis. Please enclose a detailedexplanation for cases of: Prior jury service (provide appropriate date(s) of service and court)Medical (must submit a current letter on letterhead from healthcare provider) Financial hardship (not being compensated by your employer is not grounds for excusal) Age: (persons seventy-five (75) and older may contact the court foran affidavit form requesting an exemption)Not a resident of the State of New Mexico or County (please submit proofof residency, such as a current driver222s license or a voter registration card) Caregiver: (must submit a current letter on letterhead fromhealthcare provider)Nursing mother (a current letter on letterhead from healthcare provider required if requesting second postponement) Student or teacher (request to be postponed until school breaks - please provide below thedates when your school break begins and ends): Other: PLEASE NOTE: Unless you receive a letter from the court stating you are excused fromattending jury service, you MUST appear on the date required by the court. Not showing up forjury duty when summoned is called Failure to Appear and can result in a fine of up to five American LegalNet, Inc. www.FormsWorkFlow.com hundred dollars ($500), up to six (6) months in jail, or both. Section 31-19-1 NMSA 1978. Youcan call the jury division to check on the status of your excusal or postponement. I swear or affirm that the information I have provided is true and correct to the best of myknowledge. I am aware that failure to submit required documentation may result in the denial ofmy request. Signature of prospective jurorDateSignature of the person preparing this form, Dateif different from prospective jurorPlease return completed Juror Qualification and Juror Questionnaire forms to the courtlisted on the summons you received.[Adopted by Supreme Court Order No. 17-8300-016, effective December 31, 2017.] American LegalNet, Inc. www.FormsWorkFlow.com