COURTS, JUDICIAL OFFICERS AND PROCEEDINGS IN CIVIL CASES
ACTIONS AND PROCEEDINGS THEREIN
OFFICE OF JURY COMMISSIONER FOR THE COMMONWEALTH
Juror confirmation form included with summons
Section 21. Enclosed with the juror summons shall be a juror confirmation form. When completed by the juror, this form shall certify whether or not the juror is qualified to serve as a trial or grand juror. The form shall contain the following: a place where the juror may insert the month, day, and year, and an alternate month, day, and year, to which the juror elects to postpone his juror service; a place where the juror may make or acknowledge a declaration that hardship would be imposed upon him if he were required to serve at the court location to which he was summoned; a place where the juror may designate a more convenient jury-trial location within the judicial district; a place where the juror may insert name and address corrections, if applicable; and such other information and instructions as the jury commissioner deems appropriate. The form shall also contain a place for the signature of the juror, and it shall be signed under the penalties of perjury.