Jury Services Inc.   

 

   Evaluation Request Form  

   Please fill out the following information then press "Submit Request".  
                        (Required fields in bold)                     

Name
Address
City
State
Zip
Phone
Fax
Email

Question to be answered / Comments:                                        

Do you have a need for a case evaluation? Yes             No

Case type              Federal-Civil     Federal-Criminal

                                          State-Civil         State-Criminal

Jurisdiction

Judge
Trial Date

Please explain the case:

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