Model Petit Jury Summons & Questionnaire – Pop. 1,000 to 200,000
Texas · Texas Judicial Branch
This form is a summons and questionnaire used to ask if a person is eligible for jury service. It asks for personal details, education level, employment information, and whether the person has served on juries before.
Where this fits in a case
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This form is used when a county has a population between 1,000 and 200,000 and is required by law for jury service.
Prepared by the court or clerk.
Common questions
- What is this form for?
- This form serves as a summons and questionnaire for jury service. It collects personal information to determine if you are eligible to serve on a jury.
- Do I have to fill out this form?
- You must report for jury service unless you claim an exemption, report a disqualification, or request to postpone your service.
- What happens if I give false information?
- A person who knowingly gives false information on this form can face a contempt action, which may include a fine.
Revision history
No changes recorded since we started tracking this form on October 9, 2026.
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