Was there evidence the defendant was under the influence of narcotics or dangerous drugs
at the time of the offense? Yes [ ]No [ ]
D. Representation of defendant
(If more than one counsel served, answer these
questions as to each counsel and attach to this report.)
- Date counsel secured: ____________________
- How was counsel secured:
- [ ] retained by defendant
- [ ] appointed by court
- If counsel was appointed by court was it because
- [ ] Defendant was unable to afford counsel?
- [ ] Defendant refused to secure counsel?
- [ ] Other (explain)
______________________________________________________
______________________________________________________
______________________________________________________
- How many years has counsel practiced law?
0 to 5 [ ] b. 5 to 10 [ ] c. over 10 [ ]
- What is the nature of counsels practice?
mostly civil [ ]b. general [ ]c. mostly criminal [ ]
- Did the same counsel serve throughout the trial?Yes [ ] No [ ]
- If not, explain in detail.
______________________________________________________
______________________________________________________
______________________________________________________
______________________________________________________
E. GENERAL CONSIDERATIONS
- Did race appear as an issue in the trial? Yes [ ] No [ ]
- Was there extensive publicity in the community concerning the case? Yes [ ] No [ ]
- Was the jury impermissibly influenced by passion, prejudice, or any other arbitrary
factor when imposing sentence? Yes [ ] No [ ]
- If the answer is yes, explain:
______________________________________________________________
______________________________________________________________
______________________________________________________________
- In your opinion, was the death sentence imposed in this case appropriate? Yes [ ] No [ ]
General comments concerning your answer:
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________
_______________________________________________________________________

FORMS FOR REQUIRED JURY CERTIFICATES
These certificates are required by Rule II (A) (6)
of the Unified Appeal Procedure.
(NOTE: To convert a decimal number to percentage notation,
move the decimal point two places to the right. Example: .055 = 5.5%)
Grand Jury Certificate
(download this form in Adobe format, .PDF)
This court has reviewed the Grand Jury List for________________County
from which the grand jury was selected that rendered the indictment in this case. This
Grand Jury List was last revised inthe year ____.
The following categories are cognizable groups in this
county within the meaning of the Unified Appeal and current state and federal law:
A. Males, B. Females, C. African Americans, D. Whites, E.
_______________, F. ________________
The total county population according to the most recent decennial
census is __________ .
The total county population over 18 years old, according to the most
recent census is ________.
The total number of persons on the grand jury list is ___________.
For each cognizable group listed above, calculate the
percentage of the over-18 population of the county represented by the cognizable group, as
follows:
- Males
- The total population over 18 years old in the county is _____.
- The total population of cognizable group A (males) is _____.
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of males on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: ______%
- Females
- The total population over 18 years old in the county is _____
- The total population of cognizable group B (females) is _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of females on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: ______%
- African Americans
- The total population over 18 years old in the county is _____
- The total population of cognizable group C (African Americans) is _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of African Americans on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- Whites
- The total population over 18 years old in the county is _____
- The total population of cognizable group D (whites) is _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of whites on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- ________________
- The total population over 18 years old in the county is _____
- The total population of cognizable group E is _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of cognizable group E on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- _______________
- The total population over 18 years old in the county is _____.
- The total population of cognizable group F is _____.
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the grand jury list is _____.
- The number of cognizable group F on the grand jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
This court is satisfied that the identified cognizable groups are
adequately represented on the grand jury list.

Traverse Jury Certificate
(download this form in Adobe format, .PDF)
This court has reviewed the Traverse Jury List
for________________County from which the
defendants traverse jury panel will be selected. This Traverse
Jury List was last revised in the year
____.
The following categories are cognizable groups in this
county within the meaning of the Unified Appeal and current state and federal law:
A. Males B. Females C. African Americans D. Whites E. _______________
F. ________________
The total county population according to the most recent decennial
census is __________ .
The total county population over 18 years old, according to the most
recent census is ________.
The total number of persons on the traverse jury list is ___________.
For each cognizable group listed above, calculate the
percentage of the over-18 population of the county represented by the cognizable group, as
follows:
- A. Males
1. The total population over 18 years old in the county is _____.
2. The total population of cognizable group A (males) is _____.
3. Divide answer 2 by answer 1, move the decimal 2 places to the right:
_____%
4. The number of people on the traverse jury list is _____.
5. The number of males on the traverse jury list is _____.
6. Divide answer 5 by answer 4, move the decimal 2 places to the right:
_____%
7. Subtract the larger from the smaller; the difference must be less
than 5%: _____%
- B. Females
- The total population over 18 years old in the county is _____
- The total population of cognizable group B (females) is _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the traverse jury list is _____.
- The number of females on the traverse jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- African Americans
- The total population over 18 years old in the county is _____
- The total population of cognizable group is C (African Americans) _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the traverse jury list is _____.
- The number of females on the traverse jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- Whites
- The total population over 18 years old in the county is _____
- The total population of cognizable group is D (whites) _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the traverse jury list is _____.
- The number of females on the traverse jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- _______________
- The total population over 18 years old in the county is _____
- The total population of cognizable group is E _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the traverse jury list is _____.
- The number of females on the traverse jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
- _______________
- The total population over 18 years old in the county is _____
- The total population of cognizable group is F _____
- Divide answer 2 by answer 1, move the decimal 2 places to the right: _____%
- The number of people on the traverse jury list is _____.
- The number of females on the traverse jury list is _____.
- Divide answer 5 by answer 4, move the decimal 2 places to the right: _____%
- Subtract the larger from the smaller; the difference must be less than 5%: _____%
This court is satisfied that the identified cognizable groups are
adequately represented on the traverse jury list.

G. CHRONOLOGY OF CASE
Elapsed Days
| Date of offense |
|
| Date of arrest |
|
| Date trial began |
|
| Date sentence imposed |
|
| Date motion for new trial ruled on |
|
| Date trial judges report
completed |
|
| Date received by Supreme Court* |
|
| Date sentence review completed |
|
| Total elapsed days* |
|

(*To be completed by Supreme Court)
This report was submitted to the defendants counsel for such comments as counsel
desired to make concerning the factual accuracy of the report, and
- [ ] Defense counsels comments are attached
- [ ] Defense counsel offered no comments
- [ ] Defense counsel has not responded
___________________
(Date)
______________________________________
Judge, Superior Court of
_________________________________ County
