Juror ID:

FINAL Juror ID: UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK X UNITED STATES OF AMERICA -V- GHISLAINE MAXWELL, Defendant. INSTRUCTION SHEET Dear Juror: X 20 Cr. 330 (MN) JURY QUESTIONNAIRE Please call on November 15, 2021 after 6:00 p.m. for further reporting instructions. Please bring this instruction sheet with you to the courthouse if you are instructed to return. -1- EFTA00077967 UNITED STATES DISTRICT COURT SOUTHERN DISTRICT OF NEW YORK CONSTANCE BAKER MOTLEY JURY ASSEMBLY ROOM 160 SECTION I: JUROR INFORMATION ALL FIELDS IN THIS SECTION MUST BE COMPLETED TO ENSURE YOU RECEIVE YOUR PAYMENT FOR SERVICE Full Name: •Address: Home Phone # Last Fiat M I. Street Address City State Zip Code Aportment/Unit Business Phone I Cell Phone I *NO P.O. BOXES. YOU MUST PROVIDE A RESIDENTIAL ADDRESS FOR MILEAGE REIMBURSEMENT. Social Security # PLEASE SELECT ONE NOTE: ATTENDANCE LETTERS WILL BE MAILED 21 DAYS AFTER SERVICE PRINT ATTENDANCE LET