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I n c o m e A G I M i n u s u c t i o n s f r o m a d j u

I n c o m e A G I M i n u s u c t i o n s f r o m a d j u 2025

I n c o m e A G I M i n u s u c t i o n s f r o m a d j u Preview on Page 1

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4.6 out of 5

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The document is a confidential financial questionnaire for grand jurors in Massachusetts, outlining compensation details for their service. It specifies that jurors must fill out the form and bring it to court, detailing their employment status, daily wages, and any travel or childcare expenses incurred. Compensation is provided by the Commonwealth after the third day of service, with specific guidelines on how much can be claimed based on employment status.

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Click ‘Get Form’ to open it in the editor.
Begin by entering your Badge Number at the top of the form. This is essential for identification.
Indicate your employment status by checking 'YES' or 'NO'. If you are employed, proceed to provide your employer's name and address.
For the first three days of service, specify any travel, childcare, and out-of-pocket expenses you expect to incur, up to $50 per day.
Complete section 2 based on whether you are being paid in full by your employer or not. Make sure to check only one option.
Fill in your regular daily wage and the amount you will be paid by your employer in section 3.
Finally, sign the form under penalties of perjury and ensure all information is accurate before submission.

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Versions	Form popularity	Fillable & printable
2019	4.6 Satisfied (58 Votes)
2015	4.1 Satisfied (44 Votes)

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