Jury Questionnaire Frequently Asked Questions
Questionnaire Form
Medical or Disabled
Breastfeeding Mother
Age, Care Home, or Deceased
Incarcerated
Away From Island
Military
U.S. Citizen
Individuals in household with same name
Where can I get a replacement jury questionnaire form?
If you have lost or misplaced the jury questionnaire that was mailed to you, please contact your Circuit for a replacement.
- First Circuit – O’ahu: (808) 539-4360
- Second Circuit – Maui, Molokaʻi, Lanaʻi: (808) 244-2706
- Third Circuit – Island Of Hawaiʻi: (808) 961-7412
- Fifth Circuit – Kauaʻi, Niʻihau: (808) 482-2349
Disability exemption?
According to the HRS 612-3, the term “disability” means the state of having a physical or mental impairment that substantially limits one or more of a person’s major life activities, having a record of such an impairment, or being regarded as having such an impairment.
A person claiming disqualification due to a disability must respond to the Jury Questionnaire. If the person named on the questionnaire cannot complete the form, a relative, representative or other person may complete the form. The person completing the form must enter his or her name in question 12 of the jury questionnaire and state the reason for completing the form.
The person claiming disqualification due to a disability must submit a physician’s or physician assistant’s certificate as to the disability. Attach the certificate to your jury questionnaire and place in the envelope provided.
If you are unable to submit a medical certificate within the 10 day deadline, you will have an opportunity to submit one if you are summoned. PLEASE NOTE: This does not include a temporary medical condition.
Breastfeeding mother?
If the person named on the questionnaire is currently breastfeeding a child two years of age or younger, they can be exempt from jury duty. To claim this exemption, answer “Yes” to question 7 and shade in bubble 9. Attach a copy of the child’s birth certificate to the questionnaire. Please do not send the original certificate.
Juveniles?
If the person named on the questionnaire is under the age of 18, enter the age in question 3 and who completed the form in question 12 or return the questionnaire with a note attached.
Care home?
If the person name on the questionnaire lives in a care home, enter your name in question 12 and reason why you are completing the form or you may return the questionnaire with a note attached to indicate the person is “in a care home” or “unable to complete the form”.
80 years or older?
If the person named on the questionnaire is 80 years or older, they can be exempt from jury duty. To claim this exemption, must state age for question 3 and must shade in bubble 8 for question 7.
Deceased?
If the person named on the questionnaire is deceased, return the questionnaire with a note to indicate the date of death or attach a copy of the death certificate. Please do not send the original certificate.
Incarcerated?
If the person named on the questionnaire is incarcerated, return the questionnaire with a note to indicate the person is “incarcerated”.
Vacation?
If the person named on the questionnaire is on vacation, complete the form as best you can. Enter your name in question 12 and reason why you are completing the form or you may return the questionnaire with a note attached to indicate the person is “out of town”; however, the attachment does not automatically excuse a person from jury service.
Student away at college?
If the person named on the questionnaire is a student away at college, enter your name in question 12 and reason why you are completing the form or you may return the questionnaire with a note attached to indicate the person is “away at college”; however, the attachment does not automatically excuse a person from jury service.
No longer reside on island or out of state?
If you no longer reside on the island, return the questionnaire with a note attached to indicate “no longer a resident”. Answer “No” to question 2 and enter the current address in question 18.
Part time resident?
If the person named on the questionnaire is a part time resident, return the questionnaire with a note attached and provide the primary address; however, the attachment does not automatically excuse a person from jury service.
Active military?
If the person named on the questionnaire is in the military, on active service, and deployed out of state, answer “Yes” to question 7 and shade in bubble 3.