Volunteer Juror Request To: Date: Court Clerk of ______________________ County ____________________________ Please be advised that by my signature below I am expressing my desire to be considered for Grand or Petit jury duty in _____________________ County. Being a citizen of the United States, eighteen (18) years of age or older, and a resident of _____________________ County, I certify that, to the best of my knowledge, I meet all other qualifications for jury service. I therefore respectfully request that my name as shown below be included with those other residents of this county from which the necessary jurors will be randomly selected for service in 20_____. I understand that jurors are randomly selected, and that submitting this form does not guarantee that I will be selected for jury service. Printed Name: ____________________________________________________ Address: ____________________________________________________ ____________________________________________________ City State Zip DOB: ____________________________________________________ I hereby certify and affirm that the foregoing facts are true and correct to the best of my knowledge. Dated this ______ day of ______________________, 20_____. _________________________________ Signature INSTRUCTIONS TO COURT CLERK: Provide a copy of this form to the AOC for processing. By Regular Mail to: Administrative Office of the Courts Attn: Jury Management Team 2100 N. Lincoln Blvd, #3 Oklahoma City, OK 73105 Revised 8/2014 Or by Email to: AllJuryManagementTeam@oscn.net American LegalNet, Inc. www.FormsWorkFlow.com