(a) The clerk shall prepare an alphabetical list of the name in the master jury wheel, which shall not be disclosed to any person other than pursuant to this chapter or specific order of the court. The clerk shall have delivered to every person whose name appears on such list a juror qualification form accompanied by instructions to fill out and return the form by mail or in person to the clerk within ten days after its receipt. The form shall be subject to approval by the court as to matters of form and shall elicit the name, address of resident, age of the prospective juror, other information pertinent to disquali-

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CH. 22 TRIAL BY JURY

fication or exemption from jury service and such other matters as may be ordered by the court. The form further shall contain the prospective juror’s declaration that his responses are true to the best of his knowledge and his acknowledgement that a willful misrepresentation of material fact may be punished by a fine of not more than $500 or imprisonment for not more than thirty days, or both. Notarization of the juror qualification form shall not be required. If the prospective juror is unable to fill out the form, another person may do it for him and shall indicate that he has done so and the reason therefor. Upon failure or refusal of any person duly receiving the juror qualification form to complete and return it as required, or in case of an omission, ambiguity, or error in a return form, the court, after first summoning the person to appear before the clerk to complete or correct the form, may punish the person for contempt.

(b) At the time of his appearance for jury service, or at the time of any interview before the court or clerk, any prospective juror may be required or permitted to fill out another juror qualification form in the presence of the court or clerk, at which time the prospective juror may be questioned, but only with regard to his responses to questions contained on the form and grounds for his exemption, excuse or disqualification. Any information thus acquired by the court or clerk shall be noted on the juror qualification form.

(c) The clerk may in his discretion, by court process, summon prospective jurors before him for examination.

(d) Any person who willfully misrepresents a material fact on a juror qualification form for the purpose of avoiding or securing service as a juror is guilty of a petty misdemeanor.

SOURCE: CCP § 680.12.