PLEASE ANSWER ALL QUESTIONS COMPLETELY AND SIGN AND RETURN THIS QUESTIONNAIRE IMMEDIATELY. The Court will be contacting you if this form is not returned. EVEN IF YOU CLAIM A JUROR EXCUSE. FAILURE TO RETURN THIS QUESTIONNAIRE CAN RESULT IN CONTEMPT OF COURT CHARGES.
NOTE: The Ohio Supreme Court has decided that your responses [other than your phone number] on this form may be subject to public disclosure. If you believe you need to keep any response private, you may request a hearing before the judge with the court reporter and attorneys for the case present to determine whether the response may be kept private.
