Lost Summons Form

This form is 8.5 inches by 14 inches. Only the bottom portion of the 1st page needs to be completed and returned.

Persons receiving a jury summons from the Yakima County Clerk's Office have been randomly chosen from the pool of prospective jurors.

Prospective jurors must complete and return the juror questionnaire (PDF) portion of the summons within 5 days of receipt. All information received will be treated confidentially. It is important to provide complete information so that the court can either qualify you to serve, reschedule your service, or excuse you from service.

Special Circumstances - Limited Assignment
If a prospective juror encounters circumstances such as personal emergencies, reasonable accommodations will be made to defer service to a later date, or schedule that juror for, what Yakima Courts refer to as, a ‘limited assignment.' Each special circumstance must be addressed on an individual basis and is required to be placed in writing by the prospective juror and forwarded to the Clerk's Office. The Court will then review such request and respond, generally in writing.
  • If the summons is addressed to someone residing away from home, please forward it to them to complete and return to our office (such as college students, military personnel or missionaries, or out-of-area employment).
  • If the summons is addressed to someone who is unable to write or corresponded in English, someone may assist in writing the prospective jurors answers on the form but that person must indicate on the bottom or back of the form, the name of the person who assisted in filling out the form and the relationship to the prospective juror (brother, child, spouse, friend, legal Power of Attorney.) With the exception of a legal Power of Attorney, the prospective juror must however sign the form to indicate that they agree with what was written on their behalf. Power of Attorneys must attach a copy of that document to the returned summons.