UNITED STATES DISTRICT COURT
          Central District of California

JURY QUESTIONNAIRE

INSTRUCTIONS FOR COMPLETING JURY QUESTIONNAIRE

This Questionnaire is for use in a case in the United States District Court. Your responses will only be used for jury selection purposes. You may request that your response to any of the numbered questions on the Questionnaire be considered "Confidential" by checking the box directly below that question.

  • Please make your answers as thorough as possible. You may use the last page to write additional information if needed.


  • Do not ask anyone for help in filling out the Questionnaire, including family members, friends or the court staff. Do not discuss the contents of the Questionnaire, any of the questions in it, or any of your answers, with anyone. Your answers must be your own, truthful answers, and you will be declaring under penalty of perjury that your answers are truthful.


  • Do not do any research – using the Internet or any other source – about any of the information contained in this Questionnaire.
Please make sure all information is correct before submitting the Questionnaire. Questionnaire cannot be retrieved or edited after submittal.


Participant #: Last name: First name:

General Information

1.

Your age:

2.

Are you:

3.

What is your current occupation or employment, and the nature of the business or organization where you work? If you are retired or presently unemployed, describe your last employment.

DO NOT INCLUDE THE NAME OF YOUR SPECIFIC EMPLOYER OR THE LOCATION WHERE YOU WORK.

  1. Length of employment:
  2. Job description:
  3. Do you have supervisory responsibilities? If so, please explain.
  4. What other types of jobs have you held as an adult?

4.

What are the occupations of the persons you live with, and how are they related to you?

5.

If you have any adult children or adult grandchildren, please give their occupation.

6.

What is the highest formal education level you have completed? (Please list any degrees with the field involved.)


Case Information

7.

Have you ever worked for any of the companies listed below?
  • 21ST CENTURY REAL ESTATE INVESTMENT CORP., located in Rancho Cucamonga, California
  • 21ST CENTURY LEGAL SERVICES, INC., located in Rancho Cucamonga, California
  • TRANSITIONAL CORPORATION OF AMERICA, located in Rancho Cucamonga, California
  • FIDELITY NATIONAL LEGAL SERVICE, INC., located in Rancho Cucamonga, California
  • EAST COAST MANAGEMENT, INC., located in Rancho Cucamonga, California
  • PC SERVICES, INC., located in Rancho Cucamonga, California
  • CG POWER, INC., located in Rancho Cucamonga, California
If you answered "Yes," please describe which company or companies you worked for, the position or positions you held, and the time period of employment.



8

Do you have a close family member or friend who worked for any of the companies listed above?

If you answered "Yes," please describe your relationship with the former employee (for example, spouse, parent, sister, roommate, etc.); the company or companies the person worked for; the position or positions held; and the time period of employment.



9.

Have you, or any persons you live with, or any of your close friends or relatives, ever been a customer of, or been solicited to be a customer of, any of the companies listed above?


If you answered "Yes," please list (a) which company or companies you were a customer of, or were solicited by; (b) whether or not you entered into a contract or transaction with the company; and (c) the approximate date(s) of any transaction or contact.



10.

Do you, or any persons you live with, or any of your close friends or relatives, work in the real estate or mortgage loan industries?

If you answered "Yes," please describe your position and work duties, or those of the friend or relative working in the real estate or mortgage industry.



11.

Within the last 15 years, have you, or any persons you live with, or any of your close friends or relatives, worked in the real estate or mortgage loan industries?

If you answered "Yes," please describe your position and work duties, or those of the friend or relative who worked in the real estate or mortgage loan industry.


12

Have you, any persons you live with, or any close friends or relatives, ever applied for or sought a real estate loan modification?

If you answered "Yes," please describe the (approximate) date of the application, the company or lender from whom the modification was sought, and whether or not a loan modification was successfully obtained.



13.

Have you, or any persons you live with, or any close friends or relatives, owned property that was the subject of a foreclosure proceeding by the lender?

If you answered "Yes," please state the approximate date of the foreclosure, the state in which the property was located, and the name of the lender on the property.



14

Have you, or any persons you live with, or any close friends or relatives, owned property that was the subject of a short sale, that is, a sale for less than the amount owed to the lender, while a foreclosure was pending?

If you answered "Yes," please state the approximate date of the foreclosure, the state in which the property was located, and the name of the lender on the property.



15.

Have you, any persons you live with, or any close friends or relatives had a particularly bad experience with an agent, mortgage broker, lender, or principal in a real estate transaction?


If you answered "Yes," please describe the experience, state your relationship to the person(s) who had such experience, and state whether a claim or lawsuit was filed.



16.

Have you, any persons you live with, or any close friends or relatives, ever filed a petition for bankruptcy protection?

If you answered β€œYes,” please state the type of petition filed (Chapter 7, Chapter 11, Chapter 13), and the outcome of the bankruptcy proceeding (for example, discharge of all debts, dismissal of case, etc.)



Estimated Length of Trial


THIS TRIAL WILL BEGIN ON TUESDAY, MAY 5, 2015, AND IT IS ESTIMATED THAT IT WILL LAST APPROXIMATELY 8 WEEKS. THE JURY WILL BE REQUIRED TO ATTEND TRIAL DURING THIS PERIOD ON TUESDAYS THROUGH FRIDAYS, FROM 9:00 A.M. TO 4:30 P.M.

17.

Are you able to serve on a jury for this period, that is, for approximately eight weeks?

If you answered "No," please explain why you are not available to serve as a juror for this period. Be as specific as possible regarding your ground(s) for claiming that jury service on this case would be an extraordinary hardship for you. Please include detailed information regarding any medical, financial or other situation you believe supports any request to be excused from serving on this case.




18.

Is there anything you would like to bring to the Court's attention that might in any way affect your ability to be a fair and impartial juror in this case?



Additional Explanation






I declare under penalty of perjury that all answers are true to the best of my knowledge and belief.

Please type your full name (as you would sign it) into the "/S/" signature box and click "Submit" to accept your answers.
/S/
Date:
Please make sure all information is correct before submitting the Questionnaire. Questionnaire cannot be retrieved or edited after submittal.