JURY SUMMONS

You are hereby notified that you have been selected for jury service in the trial courts of Loudon County, Tennessee. You must report to Upstairs courtroom at the courthouse in Loudon, Tennessee, on [insert report date] at [insert report time]. Unless you are notified by the court that you are not required to appear, you are subject to being held in contempt of court and being fined up to five hundred dollars ($500.00) plus court costs if you fail to appear.

If, in order for you to report for jury service or serve as a juror, you require assistance or modification due to a qualified disability, please contact Americans With Disabilities Act Coordinator, Brian Brown, at 865-988-4077.

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JUROR QUALIFICATION FORM

IF YOU ARE INELIGIBLE TO SERVE, WISH TO BE EXCUSED, OR WISH TO POSTPONE YOUR SERVICE, RETURN THIS PORTION TO THE COURT BY MAIL WITHIN 10 DAYS

NAME AND ADDRESS: [insert juror’s name and address]

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ELIGIBILITY: A person is only eligible for jury service if he or she is at least 18 years of age, is a citizen of the United States, has been a resident of [insert county] County for at least 12 months, has not served as a juror during the previous twenty-four (24) months, and has not been convicted of perjury, subornation of perjury, a felony, or any infamous offense. If you believe you are ineligible to serve, list the reason(s) below. If your ineligibility is due to a criminal conviction, list the name(s) of the offense(s) of which you were convicted: ____________________________________________________________________________________

POSTPONEMENT OF SERVICE: Jurors may request a temporary postponement of their jury service. If you wish to request a postponement, complete the following: 1. Have you previously been granted a postponement of jury service? _ Yes _ No; 2. Choose a month, by circling one, from the following list of months, indicating when you will be available to complete your service; January, March, May, July, September, and November. 3. If you have previously been granted a postponement, list the extraordinary event, such as a death in your immediate family, sudden grave illness, natural disaster, or national emergency which you believe qualifies you for another postponement: ___________________________________________________________________________________

EXCUSE FROM SERVICE: Jurors will only be excused if serving will cause an undue or extreme physical or financial hardship. Such a hardship may be present if the juror has a mental or physical condition which causes the juror to be incapable of performing jury service, or if the juror would: (a) be required to abandon a person under such juror's personal care or supervision due to the impossibility of obtaining an appropriate substitute caregiver during the period of participation in the jury pool or on the jury; (b) incur costs that would have a substantial adverse impact on the payment of the juror's necessary daily living expenses or on those for whom such juror provides the principle means of support; (c) suffer physical hardship that would result in illness or disease; or (d) be deprived of compensation due to the fact that the prospective juror works out-of-state and the out-of-state employer is unwilling to compensate the juror, or that the prospective juror is employed by an employer who is not required to compensate jurors and declines to do so voluntarily. An undue or extreme physical or financial hardship does not exist solely based on the fact that a juror will be required to be absent from the juror's place of employment. If you wish to assert such a hardship, explain the nature of the hardship and enclose an affidavit, income tax returns, medical statement from a licensed physician, proof of dependency or guardianship, or any other documentation which may be relevant to your request. Failure to provide satisfactory documentation may result in the denial of your request.______________________________________________________________________________