USA Supplemental Juror Information

If a juror receives at least $600 in a calendar year for jury attendance fees, they must provide their social security number to the Federal Judiciary by filling out this United States District Court form.

• This is a free PDF form which can be completed by filling in the blanks, printing and signing the form.
• It can be used in any District Court, by choosing the appropriate jurisdiction in the drop down menu.

Supplemental Juror Information, US District Court Form AO 229S (rev 11/10).