Fillable Juror Affidavit Juror Affidavit (Superior Court of California)

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Juror Affidavit Juror Affidavit (Superior Court of California)

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Created 12-16-19
Superior Court of California, County of San Bernardino
Juror ID#:
JUROR AFFIDAVIT
PLEASE COMPLETE - PRINT CLEARLY
You are currently on felony probation, parole, postrelease community supervision,
mandated supervision. (25)
Yes
No
You are currently required to register as a sex offender based on a felony conviction
(Penal Code 290). (99)
Yes
No
None of the above apply to you.
Yes
No
I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Signed:
Dated:
Name:
Telephone #:
You have a malfeasance in office conviction and your civil rights have not been restored.
Yes
No
Yes
No
8303 Haven Avenue Rancho Cucamonga, CA 91730
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Juror Affidavit Juror Affidavit (Superior Court of California)

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Completed 16 July 2020

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