Juror Change of Address Form | Long County Superior Court Clerk

Name*
First Middle Last Suffix
Current Mailing Address
Street Address Address Line 2 City State ZIP Code
Current Street Address
Street Address Address Line 2 City State ZIP Code
Former Mailing Address
Street Address Address Line 2 City State ZIP Code
Home Phone
Work Phone
Cell Phone
Email
Date of Birth
Date Format: MM slash DD slash YYYY
CAPTCHA
By submitting this form, I certify this information is true and correct. I understand that providing false information will subject me to criminal penalties, as provided by the Georgia Computer Protection Act and Georgia Laws relating to providing false information to a public official.