Jury Questionnaire Frequently Asked Questions

Questionnaire Form

Medical or Disabled

Age, Care Home, or Deceased

Incarcerated

Away From Island

Military

Not a U.S. Citizen


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, Moloka'i, Lana'i: (808) 244-2706
  • Third Circuit - Island Of Hawai'i: (808) 961-7412
  • Fifth Circuit - Kaua'i, Niihau: (808) 482-2394

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Disability exemption?

HRS 612-3 (definition) "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 should 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 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 still have an opportunity to submit one if you are summoned. PLEASE NOTE: This does not include a temporary medical condition.

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 should 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 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 still have an opportunity to submit one if you are summoned. PLEASE NOTE: This does not include a temporary medical condition.

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Juveniles?

If the person named on the questionnaire is below the age of 18, enter the age in question 3 and complete question 12 or return the questionnaire with a note attached.

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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".

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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, answer question 3 and question 7 only. For question 7, shade in bubble 8.

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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.

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Incarcerated?

If the person named on the questionnaire is incarcerated, return the questionnaire with a note to indicate the person is “incarcerated”.

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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”.

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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”.

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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". Bubble in "No" to question 2 and enter the current address in question 18.

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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.

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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.

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Proof of citizenship in a country other than U.S.?

If you are claiming that you are not a U.S. citizen, please send a copy of your document showing proof of citizenship in another country such as a green card, passport or other official record. Do not send original copies.

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