Case 2:09-cr-00183-DB Document 53 Filed 02/24/11 Page 1 of 3

Juror #
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CONFIDENTIAL

CENTRAL DIVISION

UNITED STATES OF AMERICA,

Plaintiff, JUROR QUESTIONNAIRE
INSTRUCTIONS
vs.
Case No. 2:09CR183 DB

TIM DeCHRISTOPHER,

Defendant,

TO THE JUROR:

You are a prospective juror in this case. The trial is scheduled to begin on Monday,

February 28,2011, and is estimated to last as long as four days. Each prospective juror in this

case must fill out the questionnaire that has been approved by the Court. This will save time and

assist the Court and the parties in selecting jurors for this trial. This information is for jury

selection only and will not be used for any other purpose.

The questions asked in this questionnaire could be asked in open court. You are given

more privacy by answering them in this questionnaire. YOU ARE UNDER OATH AND ARE

REQUIRED TO ANSWER THE QUESTIONS TRUTHFULLY. THE INFORMATION

PROVIDED IS EXCLUSIVELY FOR THE SELECTION OF JURORS. YOUR

ANSWERS MUST BE COMPLETE AND ACCURATE UNDER PENALTY OF

PERJURY. Please read each question carefully and answer each question completely. Please

write your answer clearly and firmly. As you are filling out the questionnaire, you are instructed
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not to discuss your answers with anyone, please do not speak with any of your fellow jurors

during this session. It is important that the answers you give be yours and yours alone.

Please answer each question as fully as you can. Being open and honest with your

answers is critical. These questions are not meant to invade your privacy, but to help select a fair

and impartial jury for this case. There may be some questions that touch on matters that you

consider personal, private or otherwise sensitive. In order to select a fair and impartial jury,

however, it is important that the Court and the lawyers have your complete and truthful answers

to these kinds of questions.

Do not leave any questions blank. If a question does not apply to you in any way, write

"N/A" (for "not applicable"), rather than leaving the form blank. If you do not understand the

question or do not know the answer, please write that response in the space provided for the

answer. If you feel the answer is too personal, please say so in the space provided. You will

have the opportunity to discuss your answer privately. If you need more space for your response,

or wish to make further comments about any questions, please use the extra sheet attached to the

back of the questionnaire; do not write on the back of any page. If you use the explanation

sheets, please be sure to indicate which numbered question you are answering.

From this moment going forward, and until you are released from jury selection process,

you must not communicate with anyone about this case or your role as a prospective juror,

including your family and friends. This is because the court requires you to use only the

information/evidence you receive in court to make your decisions and to be free from outside

influences. Yon must not read anything about the case or listen to any reports about the

case. In addition, do not communicate about or do any research about the case, the parties,

the attorneys, or the case issues through your cell phone, through email, Blackberry,

iPhone, text messaging, or on Twitter, through any blog or website, through any internet
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chat room, or by way of any posting or other use of any social networking websites,

including, but not limited to Facebook, Myspace, Linkedln, and YouTube.

You will complete and sign your questionnaire under oath. At the end of the

questionnaire, you will be asked to sign a Juror Certification that you have answered the

questions to the best of your ability and that you have complied and will continue to comply with

these instructions from the Court. Failure to abide by your certification could result in penalties

for perjury and/or a finding of contempt of court.

Thank you for your cooperation with these instructions and for your careful and honest

responses to the questionnaire.

DATED this t. tf~y of February, 2011.

~~f~~.
DE~NSON
United States District Judge