Please Note: The personal information collected on the Jury Questionnaire is authorized under section 18.2(3) of the Juries Act, and may be used for the purpose of verifying the information you have provided about your criminal record. If you have any questions about this collection, you may contact the Coordinator, Provincial Jury Operations or the Jury Selection Clerk at the Provincial Jury Centre, 80 Dundas St., Unit D, London ON, N6A 6A4 at 1-800-498-8016.

The questions of the Juror Questionnaire are set out below along with instructions for completing them.

Question 1 - Are you a Canadian Citizen?

In general, if you were born in Canada or have received your certificate of citizenship, you are a Canadian citizen. You are not a Canadian citizen if you were born in Canada and, at the time of your birth, your parents were neither citizens nor permanent residents, and if either of your parents had diplomatic status in Canada. In general, you are a Canadian citizen if you were born outside Canada and one of your parents was a Canadian citizen at the time of your birth because the parent was either born in Canada or naturalized in Canada.

If you have further questions about Canadian Citizenship status, please consult the Citizenship and Immigration website (www.cic.gc.ca) or refer to the Citizenship Act.  A copy of the Citizenship Act can be found at:  www.justice.gc.ca/eng/index.html. Once you have accessed the site, please enter "Citizenship Act" in the search engine.

Question 2 - Are you 18 years of age or older?

Please mark an "x" in the appropriate box.

If you answer "No" to either question 1 or 2, do not answer the questions in sections B and C. Go directly to section D and sign to certify that the information you have provided is true.

Question 3 - Have you attended court for jury selection in response to a summons in this or the two preceding years?

Persons who have attended for jury duty at any time within the preceding two years are not qualified to serve as jurors.

Question 4 - Does your occupation exempt you from jury service?

If you are presently employed or licensed in one of the professions listed under instruction 4 on the "instructions for completing the juror questionnaire", which accompanied the questionnaire sent to your address, you are not qualified to serve as a juror and you should mark the "yes" box with an X.

Question 5 - Do you have any physical or mental disability that would prevent you from serving as a juror?

The presiding Judge will decide whether your request for accommodation will be granted. Every effort will be made to provide necessary accommodations for people with disabilities to serve on a jury. For example: use of personal assistive devices, sign language interpreters, or other supports. If you think that any of these or other accommodations would enable you to serve on a jury, your answer to this question should be "No."

Question 6 - Have you been convicted of any criminal offence that can be prosecuted by way of an indictment for which you have not been granted a pardon?

To verify Questionnaire information, the Sheriff conducts criminal record checks, through the Canadian Police Information Centre (CPIC), on individuals randomly selected from the panel list.

Criminal offences for the purpose of this section do not include violations of provincial statutes, such as traffic law offences under the Highway Traffic Act.

If you were found guilty of an offence and have been granted a discharge or have been pardoned, for the purpose of jury service, you were not convicted of an offence and should answer "No."

Some Criminal Code offences cannot be prosecuted by way of indictment. If you have been convicted of an offence provided in the list under instruction 6 on the "instructions for completing the juror questionnaire", you should answer "No" on the questionnaire.

All other Criminal Code offences can be prosecuted by way of indictment and you should therefore answer "Yes". For example, you do not qualify for jury service if you have been convicted of shoplifting or impaired driving.

There is only one Controlled Drugs and Substances Act offence that cannot be prosecuted by way of indictment:
Possession of Marijuana, 30 grams or less, or cannabis resin, 1 gram or less.
If you have been convicted of this offence, you should answer "No". All other Controlled Drugs and Substances Act offences can be prosecuted by way of indictment and you should therefore answer "Yes" on the questionnaire.

If you have been convicted of a Criminal Code offence or Controlled Drugs and Substances Act offence that does not appear on the list, you should answer "Yes" unless you have received a pardon for that conviction.

If you answer "yes" to any of questions 3, 4, 5 or 6 do not answer the questions in section C. Go directly to section D and sign to certify that the information you have just provided is true.

Question 7 - Provide your gender and date of birth:

When indicating gender, please mark an "x" in either the Male or Female box.

Please ensure that you enter your date of birth using the following format: YY-MM-DD. For example, if you were born January 2nd, 1960, you would enter 60-01-02.

Question 8 - Provide current or most recent occupation:

Enter your current occupation. If you are retired or not working, enter your last occupation.

Questions 9a and 9b

a) Do you speak, read and understand English?
b) Do you speak, read and understand French?

If you are chosen to sit on a jury, the trial will be conducted in either English or French. If indicating a "Yes" response to English or French, you must be fluent in either language and understand it well enough to follow a trial where all evidence and legal instructions will be given in English or French, without the assistance of an interpreter.

American Sign Language (ASL) or Langue des Signes Quebecoise (LSQ) interpretation can be provided for people who are deaf, with approval by a judge.

Question 10 - Business telephone and residential telephone:

Starting with area code, please provide your business and residential telephone numbers.

To Complete the Questionnaire

Please complete the questionnaire by signing your name and indicating the date of signature. Once signed, you must return this form to the Sheriff's Office c/o the Provincial Jury Centre.

For further information about the Juror Questionnaire

• General Information
• Frequently Asked Questions

If you have any questions or if you require further assistance in completing the questionnaire, please contact the Provincial Jury Centre at 1-800-498-8016 between 8:30 am and 5:00 pm Monday to Friday.

For information about the Jury System in Ontario

• General Information

For information about Jury Duty

• General Information about Jury Duty
• Frequently Asked Questions about Jury Duty

For comments or additional questions related to jury duty, please email juryduty@ontario.ca