Jury Questionnaire Frequently Asked Questions

Questionnaire Form

Medical or Disabled

Age, Care Home, or Deceased

Away From Island

Military

Not a U.S. Citizen

Incarcerated


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

[back to top]

Medical or disability exemption?

If you are claiming an exemption due to a medical reason, attach the doctor's certificate to the questionnaire. If you are claiming an exemption due to a disability, we suggest that you use the form provided with your questionnaire. Section 1 must be completed by the person claiming disqualification because of a disability, or by a relative or representative. Section 2 must be completed by the physician's assistant. In order to determine eligibility for disqualification, attach the competed form to your Jury Questionnaire and place it in the envelope provided. If your condition is a permanent one, the doctor should state this. 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.

[back to top]

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.

[back to top]

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".

[back to top]

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.

[back to top]

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.

[back to top]

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”.

[back to top]

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”.

[back to top]

No Longer Reside on Island or Out of State?

If the person named on the questionnaire no longer resides on the island, return the questionnaire with a note attached to indicate “no longer a resident”. Answer question 2 and enter the current address in question 18.

[back to top]

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.

[back to top]

Active Military?

If the person named on the questionnaire is in the military, you must be on active service and deployed out of state. Answer question 7 and shade in bubble 3. If applicable, answer question 12.

[back to top]

Proof that you are not a U.S. citizen?

If you are claiming that you are not a U.S. citizen in question 1, please send a copy of your document showing proof of citizenship in another country such as a green card, passport or other official record.

[back to top]

Incarcerated?

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

[back to top]

Increase text sizeDecrease text sizePrint this page

© 2008 Hawaii State Judiciary. All rights reserved.

Privacy Policy  |  Terms of Use  |  Accessibility Information

HIC logo