Source: s3://data.kl3m.ai/documents/govinfo/USCOURTS/USCOURTS-cand-3_14-cv-02022/USCOURTS-cand-3_14-cv-02022-14/pdf.json

Nature of Suit Code: 442
Nature of Suit: Civil Rights Employment
Cause of Action: 28:1441 Petition for Removal- Civil Rights Act

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Case No. 14-cv-02022 NC 

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United States District Court

Northern District of California

UNITED STATES DISTRICT COURT

NORTHERN DISTRICT OF CALIFORNIA

DARYELLE LAWANNA PRESTON,

Plaintiff,

v.

CITY OF OAKLAND, et al.,

Defendants.

Case No.14-cv-02022-NC 

JURY QUESTIONNAIRE

The Court has considered the parties’ stipulated jury questionnaire, and modifies the 

jury questionnaire as follows. The questionnaire is attached, and will not include any 

identifying information about the case. Any objections may be made by September 10 at 

12:00 p.m. 

The jury will be called on September 11, 2015 at 8:30 a.m. Each party must have at 

least one attorney or other authorized individual available in the San Francisco courthouse

clerks’ office at 10:00 a.m. to photocopy and pick up the completed questionnaires. The 

parties must make at least three copies of the questionnaires, one for each party, and one 

for the Court. The original completed questionnaires will remain with the San Francisco 

courthouse. The parties must deliver a copy of the completed questionnaires to Judge 

Nathanael Cousins’ chambers in San Jose by 4:00 p.m. on Friday, September 11. The 

parties must certify at the completion of trial that they have destroyed or returned the 

questionnaires.

Case 3:14-cv-02022-NC Document 133 Filed 09/08/15 Page 1 of 6
Case No. 14-cv-02022 NC 2

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United States District Court

Northern District of California

The parties and the Court will review the questionnaires prior to calling the jury on 

Monday, September 14. The Court will provide the parties an opportunity to stipulate to 

and discuss striking jurors for cause on Monday, September 14. However, the Court will

not strike any jurors prior to that date.

IT IS SO ORDERED.

Dated: September 8, 2015 _____________________________________

NATHANAEL M. COUSINS

United States Magistrate Judge

Case 3:14-cv-02022-NC Document 133 Filed 09/08/15 Page 2 of 6
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PRINT ALL ANSWERS Juror #

Juror Questionnaire: Civil Trial

United States District Court, Northern District of California, San Francisco

FULL NAME DATE OF BIRTH:

1. What city do you live in? How long?

2. List cities where you have lived in the past 10 years: 

3. What is your highest level of education? 

4. List all degrees (with major), certificates, and licenses: 

5. What is your occupation? 

6. Your current employer: How long? 

If retired or unemployed, list your last job and date: 

7. Has your job involved the following responsibilities: 

(a) Supervising others:  Yes  No (b) Evaluating others:  Yes  No

(c) Hiring or firing others:  Yes  No

8. Do other adults live in your household?  Yes  No

If yes, what are their occupations? 

9. If you have children or step-children, please list (including children who do not live with you):

Sex Age Occupation Employer

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10. What is your marital status? 

 Married  Single, Never Married  Divorced  Separated  Widowed

11. What are/were the occupations of your parents? 

continue on next page

Case 3:14-cv-02022-NC Document 133 Filed 09/08/15 Page 3 of 6
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12. Have you or someone close to you ever had training or been employed in any of the following 

fields? (Check all that apply.)

a. Audits or compliance investigations  Yes, self  Yes, someone else

b. Human resources / personnel management  Yes, self  Yes, someone else

c. Law, any legal field  Yes, self  Yes, someone else

d. Mediation or dispute resolution  Yes, self  Yes, someone else

e. Law enforcement  Yes, self  Yes, someone else

f. Actuarial work  Yes, self  Yes, someone else

g. Courts  Yes, self  Yes, someone else

h. Legislative branch  Yes, self  Yes, someone else

If yes to any of the above, please explain: 

13. What social, civic, professional, trade, or other organizations are you affiliated with? Please note 

if you have held any offices in the organization.

14. Have you, or has a family member, ever served in the military? (Check all that apply.) 

 Yes, I have  Yes, a family member has  No

If yes: Which branch? Dates served: Rank: 

15. Have you ever had any prior jury service?  Yes, criminal  Yes, civil  No 

16. If yes, where did you serve on a jury? 

17. If yes (to #14), how many of those cases reached a verdict? 

18. If yes (to #14), were you the foreman? 

19. Have you or anyone close to you ever sued anyone, or been sued by anyone? 

 Yes, sued someone  Yes, been sued  No 

If yes, explain: 

20. Have you or someone close to you ever been involved in an incident of retaliation in the 

workplace? 

 Yes  No If yes, explain, including if it was resolved satisfactorily: 

Case 3:14-cv-02022-NC Document 133 Filed 09/08/15 Page 4 of 6
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21. Have you or someone close to you ever been a member of and/or held a position with a union? 

 Yes  No If yes, explain: 

22. Have you or someone close to you ever been employed by the City of Oakland? 

 Yes  No If yes, explain: 

23. Do you have any experience with the following: 

a. Labor negotiations  Yes  No

b. Union negotiations  Yes  No

If yes to any, please explain: 

24. What is your primary source of news? 

25. Describe your hobbies: 

26. Identify any magazines that you subscribe to: 

27. Describe any ethical, religious, or other beliefs that may prevent you from serving as a juror: 

28. Describe any disabilities that would require accommodation for you to participate in the jury:

29. Are you taking any medication or drugs which will prevent you from hearing and remembering 

testimony or seeing evidence?

 Yes  No If yes, explain: 

30. This trial will take place from 9 a.m. to 4 p.m. Monday through Friday, for up to 10 days of trial, 

plus an unknown length of jury deliberation. Do you have a hardship that would prevent you from 

serving on this jury until September 25? (A hardship is considered based upon medical need, 

severe financial hardship, care of young children or dependent adults, travel to court of more than 

75 miles, pre-paid travel, and/or an inability to understand and read English.)

 Yes  No If yes, explain: 

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31. Is there anything else that the Court and the parties should know about you that could affect your 

ability to be a fair and impartial juror in this case? 

 Yes  No If yes, explain: 

Because you must decide this case based only on the evidence received in the case and the Court’s 

instructions as to the law that applies, you must not be exposed to any other information about the case 

or to the issues it involves during the course of your jury duty. Thus, until you are dismissed from the 

jury, or the end of the case, you may not communicate with anyone in any way about the merits of the 

case or anything to do with it. This includes discussing the case in person, in writing, by phone or 

electronic means, via e-mail, text messaging, or any Internet chat room, blog, website or other feature. 

Additionally, you may not conduct any outside research of your own, including searching for

information about the case, parties, or attorneys on the internet.

I declare under the penalty of perjury that all the foregoing is true and correct, and I acknowledge 

that I have read and will abide by the Court’s instructions above.

 

SIGNATURE DATE 

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