Yost et al v. Black & Decker (US), Inc. et al

Filing 52

COURTS INTENDED JUROR QUESTIONNAIRE. Signed by Judge Jon S. Tigar on November 2, 2015. (wsn, COURT STAFF) (Filed on 11/2/2015)

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UNITED STATES DISTRICT COURT

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NORTHERN DISTRICT OF CALIFORNIA

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ARTHUR R. YOST, et al.,

Case No. 13-cv-05203-JST

Plaintiffs,
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v.

COURT’S INTENDED JUROR
QUESTIONNAIRE

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ROHM GMBH, et al.,
Defendants.

United States District Court
Northern District of California

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In advance of the trial currently scheduled for January 11, 2016, the Court wishes to solicit

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counsel’s views regarding an appropriate written jury questionnaire. The Court intends to submit

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a written questionnaire to prospective jurors by mail in advance of the trial. Counsel may ask

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follow-up questions to responses in the questionnaire and may ask additional questions during voir

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dire. The Court intends to allow counsel to conduct at least some portion of voir dire, subject to

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time limits.

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The Court has attached a proposed form of questionnaire. The Court requests that the

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parties provide the Court with a list of names of persons who may testify at trial by November 9,

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2015, so that this information can be included in the form sent to prospective jurors. The Court

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can provide additional or amended information to prospective jurors on the day of trial. Parties’

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comments, objections to the forms of question, or suggested modifications to the questionnaire

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may also be submitted by November 9, 2015. The Court will rule on any suggestions or

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objections without a hearing.

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IT IS SO ORDERED.

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Dated: November 2, 2015
______________________________________
JON S. TIGAR
United States District Judge

JUROR QUESTIONNAIRE - INSTRUCTIONS

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The integrity of our legal system depends on the fairness and impartiality of jurors. This

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questionnaire has been prepared to assist the Court and the parties in this case to determine

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whether you may have had personal experiences related to, or prior knowledge concerning, the

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issues to be decided by the jury. Please fill out this questionnaire completely in ink. Since we need

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to make copies, do not write on the back of any page. If you need more room, continue at the

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bottom or side of the page, or on the last page (noting question number).

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Please answer the questions honestly and completely. There are no right or wrong answers

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to any question. This questionnaire is part of the trial record, but will not be available generally to
the public without an order of the Court. If you find that some of the questions call for sensitive

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United States District Court
Northern District of California

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personal information that you wish not to disclose here, please indicate that in your response. You

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will be provided an opportunity to speak with the judge and/or the attorneys outside the presence

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of other jurors.
At the end of the questionnaire, you will be asked to sign the questionnaire and to declare

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under penalty of perjury that your answers are true and correct.
Thank you for your cooperation.

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JUROR QUESTIONNAIRE

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Please fill out this form as completely as possible and print clearly. Since we will make copies for
the attorneys and the Court, do not write on the back of any page.

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1.

Your name:

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Your age:

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The city where you live:

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How long you have lived there:

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4.

Your place of birth:

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Do you rent or own your own home?

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Your marital status: (circle one)
single

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married

live with partner

separated

divorced

widowed

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What is your occupation, and how long have you worked in it? (If you are retired, please
describe your main occupation when you were working).

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Who is (or was) your employer?

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How long have you worked for this employer?

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Please list the occupations of any adults with whom you live.

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If you have children, please list their ages and genders and, if they are employed, please
give their occupations.

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Please describe your educational background:

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United States District Court
Northern District of California

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Highest grade completed:

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College and/or vocational schools you have attended:

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Major areas of study:

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13.

Have you ever served on a jury before? ________ How many times?________

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If yes: State/County Court _______ Federal Court _______
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When?

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Was it a civil or criminal case?

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Did the jury(ies) reach a verdict?

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Attached is a list of the parties in this case, the law firms representing the parties, attorneys
in this case, and persons who are potential witnesses in this case. Do you know, or think
you know, any of the persons listed?
Yes:_____ No:_____

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If so, make a check next to their name.
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VERIFICATION

United States District Court
Northern District of California

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I, _____________________________, declare under penalty of perjury under the laws of the State
(PRINT FULL NAME)
of California and the United States of America, that the foregoing responses I have given on this
juror questionnaire, and on any attached sheets, are true and correct to the best of my knowledge
and belief.

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________________
DATE

_____________________________________________
SIGNATURE

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List of Parties, Potential Witnesses, and Other People Connected With This Case

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