Form Ao 205 - Summons To Appear To Complete Juror Qualification Form - United States District Court

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AO 205
(Rev. 08/09)
U
S
D
C
NITED
TATES
ISTRICT
OURT
for the
SUMMONS TO APPEAR TO COMPLETE JUROR QUALIFICATION FORM
According to the records of the court, you have failed to complete and return the juror qualification
form previously mailed to you. The completion of this form within 10 days is required by section
1864(a) of title 28, United States Code. Accordingly, YOU ARE HEREBY SUMMONED to
appear at the date, time and place specified below for the purpose of filling out such juror
qualification form.
DATE
PLACE
TIME
NOTE: If you do not respond to this summons, an order may be issued by a judge of the court
requiring you to appear before the court and show cause for your failure to comply with
this summons. A failure to show good cause for noncompliance may result in the
imposition of a $1,000 fine, imprisonment for not more than three days, an order to perform
community service, or any combination thereof, as provided by section 1864(b) of title 28,
United States Code.
CLERK
(By) DEPUTY CLERK
DATE
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