If you have received a QUESTIONNAIRE about qualification for jury service this is not a summons to appear in Court. It is a questionnaire to assist in determining whether you may be eligible to serve as a potential juror. Please read and complete the form carefully, ensuring you answer all questions and place an X in the appropriate boxes.

Questionnaires received for deceased individuals, individuals with a disability or a person with the same name residing at the same location.

1. I have received a questionnaire of a deceased individual, what do I do?
   For a deceased individual, please indicate this information on the questionnaire next to their name and return the form in the envelope provided.
   We apologize for any distress this document may have caused you or your family.
2. I have received a questionnaire for an individual with a mental disability or medical condition that would not allow them to serve as a juror. How do I respond to the questionnaire?
   For an individual who has a physical or mental disability or medical condition which would not allow them to serve as a juror, mark the yes box with an X in Question 10 and fill out the "Authorization for Doctor to Provide Medical Information" located beneath QUESTION # 10. There is no requirement to obtain or include a doctor's letter.
3. I have received a questionnaire and believe I have a mental disability or medical condition that would not allow me to serve as a juror. How do I respond to the questionnaire?
   If you have any physical or mental disability or medical condition which you feel would not allow you to serve as a juror, mark the yes box with an X and fill out the "Authorization for Doctor to Provide Medical Information" located beneath QUESTION # 10. There is no requirement to obtain or include a doctor's letter. If you do not have a physical or mental disability or medical condition which would prevent you from serving as a juror, mark the no box with an X.
4. What do I do if two individuals with the same name are residing at the same location?
   If two individuals with the same name are residing at this location and both are over 18, only one individual need complete the form and return it in the envelope provided.

Unable to Complete or Fill Out:

1. I have received a questionnaire and want to ensure I respond promptly but cannot complete it myself. Can I have someone assist me?
   If you are unable to fill out the questionnaire yourself, someone else may assist you and sign it on your behalf indicating their relationship to you at the bottom of the questionnaire.
2. I was away on vacation and the return date is past due, do I need to still complete the form?
   If you were on vacation, or the return date is past due, or your receipt of the questionnaire has been delayed, complete the form as soon as possible and return it in the envelope provided.
3. I am no longer at the address shown on the form, do I need to notify someone?
   If your address has changed from the address shown on the form, make the appropriate changes in the space to the right of the incorrect address and complete the questionnaire.
4. I have completed the questionnaire but cannot find the return envelope with the address, where do I mail the questionnaire?
   If you have mislaid your envelope and need the mailing address it is - Post Office Box 80102 Station BRM - B, Toronto, Ontario, M7Y 9T2.
5. I have received a questionnaire for someone who no longer resides at this address or is away attending an educational facility. What should I do with the questionnaire?
   If this individual is not residing at this address, or is attending an educational facility away from home, please indicate this on the space next to the address, and return the questionnaire in the envelope provided.

For comments or questions related to jury duty, please email juryduty@jus.gov.on.ca.